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library of
(Dje Unbersthj of riortt) Carolina
COLLECTION OF
NORTH CAROLINIANA
EKDO W ED BY
JOHN SPRUNT HILL
of the class of 1889
.
This book must not
be taken from the
Library building.
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orm No. 471
355-4-19-98-2800.
BULLETIN
OF THE
florth GaFolina Board of Health.
Published Monthly at the Office of Secretary of the Board, at Raleigh, N. C.
Geo. G. Thomas, M. D., Pres., Wilmington.
S. Westray Battle, M. D.,..Asheville
W. H. Hakrell, M. D., Willlamston.
John Whitehead, M. D., Salisbury.
C. J. O'Hagan, M. D., Greenville.
J. D Spicer, M. D., Goldsboro.
J L. Nicholson, M. D., Richland s.
A.W.Shaffer, San Eng., Raleigh.
Richard H. Lewis, M. D , Secretary and Treasurer, Raleigh.
Vol. XI1£ APRIL, 1898.
—r
No. yz.
ELECTION OF COUNTY SUPERINTENDENTS
OF HEALTH.
Under the law as amended by the last
Legislature, County Superintendents of
Health are to be elected annually on the
first Monday in May. We sincerely hope
that the several boards of County Commis-sioners
will elect the best man available to
this responsible office, and we especially
hope that those few boards which failed to
elect a year ago will not overlook it again.
The law is mandatory on the subject and
allows the board no discretion in the mat-ter,
and a failure to elect is a plain viola-tion
of the oath of office.
SMALLPOX IN NORTH CAROLINA.
On the 30th of March we received a
telegram from the Superintendent of
Health of Rowan county announcing "a
probable case of smallpox " at Salisbury.
A subsequent report stated . that it was
genuine and that the patient would re-cover.
The person affected was a colored
postal clerk on the run between Salisbury
and Knoxville. The source of contagion
was easily traced to a case of smallpox
which occurred and remained in the
clerk's Knoxville boarding-house. Dr.
Whitehead, the superintendent, promptly
took the necessary preventive measures
how thoroughly and successfully is at-tested
by the fact that up to this present
writing (three weeks) no new case has
occurred.
On the 14th inst. (April 1, Dr. Fletcher,
the municipal health officer of Asheville,
reported a case of smallpox in a negro
ten days from Jacksonville, Fla. As the
case occurred in a negro restaurant we
are anxious lest the disease spread, not-withstanding
the precautions taken by
the health officer.
We regret to learn that a deep prejudice
again.st vaccination crops up every now
and then, chiefly among the ignorant
—
the very element of the population which,
owing to the over-crowding and other un-sanitary
conditions usually co-existent
with ignorance, is in peculiar need oi tin-protection
afforded by vaccination. The
question is how to overcome this preju-dice.
We have more than once asked our
readers for suggestions as to the best
practical method of getting the people
vaccinated, but not one has responded. It
28o BULLETIN OF THE NORTH CAROLINA BOARD OF HEALTH.
is easy to understand why it is a problem
extremely difficult of a practical solution.
Fortunately the feeling against vaccina-tion
is sporadic, and we shall console our-self
with the hope that as time passes and
knowledge spreads this prejudice will
disappear.
Since the a. was sent to the printer
we have received the following, under
date of April 19th, from Dr. Fletcher:
" We have the second case of smallpox,
imported from Spartanburg, S. C. She
ran away from Spartanburg to prevent
being taken to the pest-house. Was
broken out when she came to Asheville.
Was in her own house from Monday
night till Friday morning before she was
discovered, and a number of people went
to see her. Both patients (negroes) are
properlv quarantined in a pest-house
which we established with difficult}-—met
with armed resistance. Judge Hoke re-fused
to enjoin our Board of Health till
we had a hearing. Long before the day
set for a hearing came I had my house
built (a comfortable two-room house)
and my patients in it. For fear of having
to pay a big bill of costs the opposition
withdrew the application for injunction.
We are vaccinating every one as fast as
possible ; are meeting with some opposi-tion.
We have a compulsory vaccination
ordinance and mean to fight it out along
these lines with tact and discretion."
It is evident that the Health Officer of
Asheville is made of the right kind of
timber.
THE HOME OF CONSUMPTION.
We print below an extremely interest-ing
communication bearing upon the pro-duction
of consumption. It indicates in
the first place that consumption is essen-tially
an indoor disease. There is great
probability that the germ which causes
consumption is quickly destroyed when
freely exposed to light and air. Indeed,
this is not a matter of conjecture, but has
been demonstrated time and again. And
while the practice of expectorating, or
spitting, on the streets is to be deprecated
—whether by consumptives or other per-sons—
the great danger comes from such
material being cast into dark, unventi-lated
rooms, where the germs may live
for an unknown time—probably for years.
It will be noted that the house referred to
below, in which fifteen persons probably,
and thirteen certainly, died from con-sumption
or tuberculosis, "is very damp
and the cellar in bad condition." and fur-thermore
it is surrounded by dense foli-age.
It has long been known that dampness
is a factor in the production of consump-tion,
probably acting as a predisposmg
cause. It has been shown for a number
of towns that subsurface drainage and
consequent drying of the soil has always
lowered the death rate from consumption
where a wet soil had been the condition
theretofore. The dense foliage spoken of
would cut off both air and light. Such a
house, becoming infected, would remain a
center of infection for a long time.
The most satisfactory part of Dr. Gas-ton's
statement is his reference to public
opinion regarding this house. It is safe
to say that no ether family will move into
it. The question may be referred to the
court to determine the power of the Board
of Health to order its destruction.
What is most needed is that public
opinion throughout the land shall be
brought to the level of that of the people
of Mineral Ridge. Not that it is neces-sary
that houses in which people with con-sumption
have lived or died need be de-stroyed,
for such houses can be made per-fectly
safe by modern methods of disin-fection.
And there seems no escape from
the conclusion that cases of consumption
should be reported to the health authori-
BULLETIN OF THE NORTH CAROLINA BOARD OF HEALTH. 28
1
ties, in order that this may be done. Fol-lowing
is the communication from Dr.
Gaston:
MiXERAi, RiDGE, O., March 29, 189S.
Dr. C. O. Probst. Sect etary State
Board of Health, Columbus, Ohio:
Dear Sir—Relative to the house in this
village, mentioned some time since, which
has sheltered so many tubercular victims,
I enclose you a history of the same as
nearly correct as I could obtain it from va-rious
sources. I am informed that it was
thoroughly disinfected about one year ago;
that the building is very damp and cellar
in bad condition; that in no way will other
residents of the town be satisfied until it
is fired. The mother refuses to give up
the house, although urged to do so by the
remaining children. The local Board has
discussed this matter, and now asks the
State Beard to take such action as they
deem best in the matter. The residents of
this place look upon the home with hor-ror,
and if the family were to move out, I
have no doubt that the building would go
up in flames inside of t\\ enty-four hours,
and not a hand would be turned to save it.
THE HISTORY OF A HOME.
This house was constructed about 1830,
and was occupied by a family of the name
of F. It is related that a young man who
lived with the family was " always ailing
and in delicate health," but the only
death was that of a baby with bowel trou-ble.
They resided in the premises until
about 1846, when the house was occupied
by a family named S. They were an un-usually
strong and healthy family when
they first came to this place, with no pre-vious
tubercular history. The first one
connected with this family to pass away
was a lady boarder, but information does
not reveal the cause of her death. It was
quickly followed, however, by the death
of two sons, two daughters, father and
mother, from tuberculosis, leaving only
one son, who had previously gone to Illi-nois
on account of his health, and who
still survives. From 1879 until now the
house has been held by the present occu-pants.
There is no history whatever of
consumption in the family prior to their
coming to this house. The daughter who
died recently was born here. Her death
was the seventh in the family in as many
years from pulmonary tuberculosis. A
sister, two brothers and a mother survive,
but the characteristic traces of the disease
are plainly visible in the faces of one
brother and the surviving sister. The
building is a story and a half high, and is
surrounded by dense foliage.
Yours truly,
Jas. E. Gaston, M. D. —Ohio Sanitary Bulletin,
We take much pleasure in printing the
above most impressive statement of facts,
for it is on the lines indicated by our
friend, Dr. Probst, viz., abundance of
fresh air and sunlight, and the thorough
disinfection of infected houses, that the
ravages of " the great white plague " can
be most effectively curtailed. As "The
Best Method of Preventing Tuberculosis '
'
has been selected by the Leader of De-bate,
Dr. Burroughs, of Asheville, for dis-cussion
at the approaching meeting of the
State Medical Society, we will reserve
what we have further to say on this—lit-erallv
from the sanitarian's point of view
—
most important subject for our next issue.
We desire, however, to call particular at-tention
to the next article as showing how
easily, simply and cheaply the disinfec-tion
can be accomplished.
FORMALDEHYDE DISINFECTION AGAIN.
During the month tests have been made
of still another, and the latest, apparatus
devised for formaldehyde disinfection.
This consists, substantially, of a copper
receiver of about half a gallon capacity,
from the bottom of which a small pipe
leads to a coil heated by a kerosene lamp.
The agent is the usual 40 per cent, for-maldehyde
solution (formalin), which is
slowly admitted to the coil, where it is
volatilized by the kerosene flame and the
resulting gases are blown through a rub-ber
tube into the room through the key-hole
of a door. It is another modification
of the Trillat autoclave, but possesses
some advantages. It is easily handled,
282 BULLETIN OF THE NORTH CAROLINA BOARD OF HEALTH.
free from danger of explosion and is op-erated
entirely outside the room to be dis-infected.
Its chief drawback is that which has
caused the abandonment of other "gen-erators"
of this type, to-wit, that when
the solution passes into the red-hot coil
the water is quickly boiled off, the solu-tion
becomes concentrated and parafor-maldehyde
is produced—consequently, a
considerable quantity of the available
formic aldehyd is blown into the room in
the polymerized state. A piece of paper
placed at the foot of the door through
which the gases were being blown gather-ed
a considerable quantity of paraform
which had dripped from the end of the
tube in the keyhole.
In the experiments, which were con-ducted
under the supervision of the agent
for the apparatus, six ounces ( 187.5 cc )
of the formalin were used 'for every 1 "OH
cubic feet of space, and the rooms were
kept closed five hours. Agar streak cul-tures
of the diphtheria bacillus and of the
B. frodigiosus were exposed in the rooms
in tubes, open and plugged, covered and
uncovered, and at different heights. In
closing his report, which is accompanied
by a detailed table, Dr. Gehrniaim says :
" We may, in general, say that the freely
exposed specimens were killed. The ger-micidal
effect was, however more marked
in specimens nearest the floor. Those
which were covered with one or more
folds of a sheet, or placed under pillows,
or in plugged tubes, were not always
killed.
'.' We were not able, in the five hours'
exposure, to obtain any greater efficiency
than with other methods of vaporizing
formaldehyde solution under pressure, or
of producing formaldehyde gas by the oxi-dation
of methyl alcohol."
Full}' as good, if not better, results
have been obtained in a number of disin-fections
during the month, made person-ally
by Dr. C. W. Behm, Medical Officer
in charge of the Disinfecting Corps. In
these disinfections formalin was also
used, but without the use of any appara-tus.
Ordinary bed sheets were employed
to secure an adequate evaporating surface,
and these, suspended in the room, were
simply sprayt-d with the 40 per cent, so-lution
through a common watering-pot
rose-head. A sheet of the usual size and
quality will carry from 150 to ISO cc. of
the solution without dripping, and this
quantity has been found sufficient for the
efficient disinfection of 1 ,000 cubic feet of
space. Of course, the sheets mav be
multiplied to any necessary number.
Cultures, both moist and dry, were ex-posed
for five hours in these experiments,
some in sealed envelopes and others
wrapped in three thicknesses of sheets or
folded inside of woolen blankets. Of the
former none showed growth after 73
hours' incubation, while the growth was
but slight in those wrapped in the blank-ets.
Surface disinfection was thorough,
while a much greater degree of penetra-tion
was shown in these expe'iments than
that secured by any other method.
The evolution of the gas from the
sprinkled sheets is exceedingly rapid
—
so much so that it behooves the operator
to vacate the room within a very few sec-onds
; while, after starting the ordinary
generator, he may remain ten minutes or
more without serious inconvenience.
When the room is opened after five hours
the density of the gas is still so great as to
preclude respiration until after doors and
windows have been opened some little
time. On the other hand, the air is
respirable within a very few minute* after
the sheet has been removed, and there is
no lingering smell of formal lehyde for
days after, as is the case where the gas is
evolved by the action of heat. This is
due to the fact that a minimum of para-form
is produced in the evaporation of
BULLETIN OF THE NORTH CAROLINA BOARD OF HEALTH. 283
the solution in this manner at the ordi-nary
temperature, and this is retained in
the meshes of the fabric, instead of being
precipitated on surfaces, to be slowly con-verted
into the gaseous form through
several days
.
If further experiments, which are now
being prosecuted by the Department,
shall confirm the results thus far obtained,
the problem of practical domestic disin-fection
by formaldehyde would seem to be
in a fair way to be solved.
—
March Report
Department aj Health City of Chicago.
WATER.
BY H. C. WOOD, M. D., PHILADELPHIA.
Many European physicians believe that
the most active cause of gastro-intestinal
disturbance in America is the habitual use
of ice water, and there can be no doubt
that flooding the stomach with large quan-tities
of ice water during eating has a ten-dency,
by lowering temporarily the tem-perature
of the viscus, as well as by dilut-ing
the gastric juice, to cause disturbances
of digestion, which, on repetition, may re-sult
in the production of gastric catarrh.
On the other hand, the habitual taking of
large amounts of water is very advanta-geous
for all gouty individuals, and in-deed
for all persons who eat more than
the needs of the system require, in which
latter class is included practically the
whole of the American people.
It would seem a prio i, probable, that
in its relations with water the human sys-tem
obeys to a greater or less extent the
ordinary physical ami chemical laws.
What is taken into the body must get out
of the body, sooner or later; and the dis-charge
of large quantities of water neces-sarily
increases the flow of secretion. The
old researches of Roux and of Boecker in-dicated
that the increase of the amount of
urine which follows the water drinking is
sometimes, but not always, accompanied
by an increase in the output of solids from
the kidneys. The cause of the differences
of effects has been shown by Meyer to de-pend
upon the condition of the body; the
excess of water in the system appears to
have very little influence upon tissue dis-integration,
but to be powerful in dissolv.
ing and carrying off—in other words, in
washing out—all excrementitious mate-rials,
whether such materials be due to
disintegration of the tissues themselves or
be educts from an excessive food supply.
The American habit of drinking water
has not, however, arisen lromthe prompt-ings
of an}- blind instinct leading the race
to attempt to wash out of the body the
products of excessive self-indulgence, or
the last taint of a gouty ancestry, but has
simply sprung from the climatic condi-tion.
The dry air (as compared with Eu-rope)
and the high temperature of the
summer months make the American throw
off water and make the system demand
water. The vacuum in the body must be
supplied. That the American people do
not drink more water than they need is
shown by the fact that the American man
is a drier individual, not only in his
speech but also in his tissues, than is the
European. True humor consists of a ker-nel
of truth surrounded by a hull gro-tesquely
unfit for it; and so the humorist
habitually expresses a physiological fact
when he makes John Bull in the cartoon
plump and succulent, and Brother Jona.
than hard and dry. Many years ago the
writer at a meeting of the physiological
sections of an International Congress,
said that a certain physiological operation
or procedure reported by European phy-siologists
did not produce the results upon
dogs which were alleged, unless indeed
the European canines were very different
from his American brothers, a suggestion
which led to a general titter until Brow-n-
Sequard got upon his feet and said that he
had studied and practiced vivisection on
284 BULLETIN OF THE NORTH CAROLINA BOARD OF HEALTH.
the two continent?, and that it was a fact
that the American people and the Ameri-can
dogs and lower animals were distinctly
different in vascularity from their respec-tive
kindreds in Europe; that operations in
vivisection which in Europe he could
scarcelv perform on account of the amount
of bleeding produced, he had done on the
American dog with almost dry tissues.
The American drinks water because he
is thirsty; he is thirsty because he sweats;
and he wants his water cold because he is
hot; the cooling of the system being de-manded,
but the cool temperature being
especiallv grateful to a heated throat.
What is the poor American to do ? He is
threatened with mummification if he does
not drink water; he is appalled by the
horrors of gastric catarrh if he does drink
water. The answer is obvious; drink wa-ter
between meals rather than at meals.
The drier the meals the less dilute the gas-tric
juice, the better theo-etically at least
is the digestion. Fortunately the ordi-nary
human being is made with a reserve
force, and so if he be in the ordinary con-dition
he need not study the number of
drops of water he takes with his meal; but
if he have any disease of the stomach or
feebleness of digestion it is well worth
while to count the drops.
Cold water has so good a taste when a
man is very heated that most people will
continue to take cold water, and a general
chilling of the body would seem some-times
to be of service. Nevertheless,
there probably are cases in which the sud-den
pouring of large masses of cold water
upon a stomach in a person who has little
reserve power has produced an immediate
violent disturbance. These cases are,
however, in our opinion, few; indeed, our
belief in their existence may be due to the
nursery teachings of our early childhood,
since if the truth must be spoken, in a
medical experience extending over thirty-five
years, we have never seen colic, col-lapse,
or any other acute symptom or con-dition
produced b}^ a cold drink. But for
fear that the nurserv bogie is the shadow
of a truth we would advise our readers
when hot to drink cold water si owlv. We
remember once, when two thirds dead of
thirst in the Texan desert, with what joy
we raised to our lips a quart mug of water
and drank it to the bottom without a
breath, but in an ordinary emergency a
half tumblerful of water, followed in a
moment or two (if it must be) by the
other half tumblerful of water, should sat-isfy
the ordinary individual.
—
American
Medico- Surg. Bulletin.
PHYSICAL EFFECTS OF ATTENDING
SCHOOL.
In what wav the bodily development of
children is affected by their attendance at
school has been closely investigated for
vears by Dr. Schmidt-Mounard, of Leip-sic,
who recently gave his results in an
address to the Lehrer-Verein of that city.
His results are as follows:
1
.
It is a difficult task to trace with ac-curacv
what effect attending school has
on the growth of children and on their
increase of weight ; but it is a fact demon-strated
beyond reasonable doubt that
children in the first vear of school attend-ance
gain less in weight and heieht than
thev do in preceding years, namely, only
one kilogram ftwo and one-fifth pounds')
in weight compared with four in early
vears, and five centimeters (two inches)
in height compared with seven before ;
and that the average proportions in this
respect are not again attained until in
later years ; and, further, that children
who do no' enter school until their
seventh year are stronger and better de-veloped
physically than those who enter
a year earlier.
2. Acute sicknesses are not caused by
the fact that children must study, but are
BULLETIN OF THE NORTH CAROLINA BOARD OF HEALTH. 285
produced by defective hygienic school-rooms.
Lack of cleanliness, of fresh air
and light, decrease the ability of children
to resist the attacks of contagious dis-eases.
This, too, becomes better in later
years.
' 3. Chronic troubles, such as weakness,
headaches, insomnia, and nervous dis-orders
in general, are found to a much
greater degree in schools of higher grade
than iu the elementary. They increase
steadily in the case of girls to the age of
pubertv, frequently troubling as many as
fifty percent., while in the case of boys
the highest percentage is thirty-five per
cent. After that age, in consequence of
the increase of weight, they decrease to
twenty-seven per cent, in the case of
girls. Eight per cent, of children about
this age suffer from insomnia cnused
chiefly by social excitement at home. In
the higher grade of schools for boys, es-pecially
when there are no afternoon re-citations
and the pupils are compelled to
take exercise, the percentage of sickness
varies from twenty to thirtv-nine ; while
in the case of those schools where there
are afternoon recitations and no enforced
exercise, the percentage runs up as high
as seventy-nine. Eighteen per cent, of
boys in such schools complained of in-somnia.
4. The cause of these troubles is to be
found largely in the extra work assigned
to children at home, such as drawing,
lessons, music lessons, and the like, as
also to the fact that in schools physical
exercise is not nude compulsory, as it
should be.
The speaker closed his address with
these words : " The children are not too
weak for our schools, and for that reason
should not cease to attend ; but, rather,
our schools make too heavy demands on
the children, and for that reason these
demands should be made lighter."
—
The
Literary Digest.
BRAIN FATIGUE IN SCHOOL WORK.
A question of interest to teachers is
raised by a recent paper by Dr. Kemsies,
the headmaster of a large German school,
who gives his personal experience of the
conditions which influence the working
capacity of his pupils. We quote from
an abstract of his article in The Hospital:
" The best work, he says, is done at the
beginning of the week, after the Sunday
holiday ; and by Tuesday afternoon it
has already begun to deteriorate. Again,
the mornings produce the best work, and
the midday rest, during which the mid-day
meal is taken, does not produce the
same recuperation as the night's rest. If
these results are to be taken as correct,
it would seem as if many of our educa-tional
customs might be reformed with
considerable advantage. We have long
thought that a reversion to the two half-holidays
would be a great advantage to
the children, however much the teachers
might dislike it, and these investigations
only tend to confirm our idea. Young
ladies, again, used to go to school in the
morning and the afternoon, with a two
hours' interval between the two sessions.
But now it is thought desirable, we sup-pose,
that they should be free to pay calls
with their mothers in the afternoons, and
everything is crowded into one long
grind of four hours in the morning.
Moreover, a modern blackboard lesson is
a very different thing from the work that
used to be done in school hours, much of
which would now lie called preparation ;
and, although as a means of teaching facts
its value is obvious, so also is its power of
producing fatigue. Curiously enough,
the German experience is thai, gymnas-tics,
which we are apt to class with play,
produce the greatest fatigue of all, ren-dering
the work done after it practically
useless. But, then, the gymnastics arc-probably
done in a class, each pupil hav-
286 BULLETIN OF THE NORTH CAROLINA BOARD OF HEALTH.
ing to do as he is told. This is practically
another lesson, and is not to be put into
the same category with half an hour in a
fives-court, or at football. It must not be
forgotten that the effort to make teaching
interesting, which is its great character-istic
in modern times, does not really
lighten the burden on the child. It
makes learning easier, but it makes him
learn more ; it keeps him always at it,
and it steals from him those moments of
torpor and stupidity, of dreams and va-cancy,
in which his little brain used to
take furtive snatches of repose."
—
The
Literary Digest.
of wan-, of water in the city of Damascus.
4 and 5. I never cared of my neighbor's
business, and I cannot say how many
camel loads are brought to or sent from
Damascus.
('). Since Allah has sent his prophet, Mo-hammed,
into the world, who has cleansed
the w>>rld with fire and sword, things are
little better, but there is much to be done
vet, and much room for improvement.
And now my sweet lamb, do not ask
anv more questions, which are neither
good for you or anybody else. This is the
first and last blank I dlled out for you.
Saeam Aeeikum.
—Public Health Journal.
OTTOMAN STATISTICS.
The Bureau of Statistics of Paris in-duced
the French Government to ex-change
statistical matters with the Tur-kish
Government. Both governments
consented, and the French Bureau of Sta-tistics
has sent blanks to be filled out and
the}- have been handed by the French
Ambassador to the Turkish authorities.
The Parisian Bureau has sent six blanks.
The questions to be answered have been
the following:
1. What is the rate of deaths of the city ?
2. What is the rate of births ?
:;. What is the supply of drinking
water ?
4. How much goods are imported ?
5. How much goods are exported ?
6. General remarks pertaining to the
welfare and health of the people.
One blank came back filled out by the
Chief Magistrate of the city of Damascus.
The blank has been filled out thus:
Answer to 1. In Damascus everybody
must die on the command of Allah. Some
die young, some die old, but everyone
must die.
:!. I cannot answer answer this question.
Allah alone knows that.
3. Since time immemorial nobody died
REVIEW OF DISEASES FOR MARCH. 1898.
(seventy-eight counties reporting.)
Eighty-one counties have Superinten-dents
of Health.
Except in the case of the more conta-gious
and dangerous diseases, the Super-intendent
has, as a rule, to rely upon his
own information alone, since few physi-cians
can be induced to report cases of
non-contagious diseases to him.
Where the number of cases is not given,
or the prevalence of a disease otherwise
indicated, its mere presence in the county
is to be understood as reported.
For the month of February the follow-ing
diseases have been reported from the
counties named:
MEASLES.—Alexander, 2 ; Beaufort,
150; Caldwell, 20; Catawba, abundant;
Chatham, 20; Chowan, 25; Davie, many:
Franklin; Iredell, a few; Jackson, 2;
Johnston; Mecklenburg; Northampton,
numerous; Person, 1; Pitt, many; Rock-ingham,
in all parts; Rowan, 3; Stokes,
25, in all parts; Surry, a few, epidemic
abating; Transylvania; Wake, 6; Warren;
Watauga, 10; Wayne, 1; Wilkes, 43; Wil-son,
100; Yadkin, 12. 27 counties.
BULLETIN OF THE NORTH CAROLINA BOARD OF HEALTH. 287
Mumps.—Clay; Macon; Sampson;
Wayne.
Whooping-cough.—Chatham, 6; Da-vidson,
in all parts; Granville; Greeue,
10; Jackson, 6; Martin, 10; Montgomery,
30; Onslow, 5; Robeson, in all parts;
Rockingham, in all parts; Rowan, 2;
Wake. 1; Warren; Washington, 25, in all
parts; Wilkes, 35; Yadkin. 16 counties.
Scarlatina.—Buncombe, quarantin-ed,
recovered; Cumberland, 1; Halifax, 1;
Moore, 1 ; Northampton, 4.
Diphtheria.—Jackson, 2; Wake, 1;
Watauga, 5; Wilkes, 5.
Typhoid Fever.—Beaufort, 2; Craven;
Jackson, 4; Johnston, 2; Mitchell, 4; New
Hanover, 2; Pitt; Rowan, r; Sampson, 2;
Surry, 1; Swain, 2; Yancey, a few. 12
counties.
Malarial Fever —Chatham, 1;
Chowan; Columbus; Gaston, 1; New Han-over,
in all parts; Onslow; Person; Row-an,
Sampson; Wilkes. 10 counties.
Malarial Fever. Pernicious.—
Wilkes.
Malarial Fever, Hemorrhagic.—
Chowan, 1; New Hanover, 1; Onslow, 1.
Smallpox.—Clay, 1; Rowan, 1.
Diarrhceal Disease s.—Mitchell,
Onslow.
Influenza.—Alamance; Caldwell, in
all parts; Cleveland; Craven; Greene;
Henderson; New Hanover; Union; Yance;
Yancey. 10 counties.
Pleurisy.—Martin.
P n E u M N 1 a.—Alamance; Catawba;
Cleveland; Craven; Gaston; Iredell; Lin-coln;
Martin; Onslow; Pasquotank; Rock-ingham;
Transylvania; Union; Yance;
Washington; Watauga; Yadkin. 17 coun-ties.
Rheumatism.—Lincoln.
Rotheln.—Sampson
.
Distemper, in Horses.—Clay, Jack-son;
Moore.
No diseases of importance are reported
from, Ashe, Bertie, Bladen, Burke, Ca-barrus,
Carteret, Duplin, Durham, Edge-combe,
Forsyth, Guilford, Haywood,
McDowell, Madison, MeckleiVburg, Or-ange,
Pender, Polk, Randolph. Rich-mond
and Rutherford.
No reports have been received from
Anson, Hertford and Perquimans.
Summary of Mortuary Reports for March,
1898 (Twenty -two Towns).
Only those towns from which certified
reports are received are included:
White. CoI'd. Total.
Aggregate popula-tion
66,639 53.3 2 i 119,960
Aggregate deaths . . 61 73 134
Representing tem-porary
annual
death rate per
1. 000 11. o 16.4 13.4
Causes of Death.
Typhoid fever 3 1 4
Malarial Fever . . 1 o 1
Pneumonia 7 10 17
Consumption 10 19 29
Brain diseases 3 1 4
Heart diseases S 5 13
Neurotic diseases . 2 o 2
Diarrhceal disease 1 2 3
All other diseases. . 23 53 56
Accident - 3 2 s
61 73 134
Deaths under five
years 10 21 31
Still-born.. 3 q i 2
BULLETIN OF THE NORTH CAROLINA BOARD OF HEALTH.
Mortuary Report for March, 1898.
Towns
BULLETIN OF THE NORTH CAROLINA BOARD OF HEALTH. 289
County Superintendents of Health.
.Dr. J. K. Stockarcl.
Dr. T. F. Stevenson.
Alamance . .
Alexander. .
Alleghany
Anson Dr. E. S. Ashe.
Ashe Dr. L. C. Gentry.
Beaufort Dr. D. T. Tayloe.
Bertie Dr. H. V. Dunstan.
Bladen Dr. Newton Robinson.
Brunswick
Buncombe Dr. I. A. Harris.
Burke Dr. J. L. Laxton.
Cabarrus Dr. J. S. Laffertv.
Caldwell Dr. A. A. Kent.
Camden No Board of Health.
Carteret Dr. F. M. Clarke.
Caswell
Catawba Dr. F. L. Herman.
Chatham Dr. H. T. Chapin.
Cherokee Dr. S. C. Heighway.
Chowan Dr. R. H. Winborne.
Clay Dr. W. E. Sanderson.
Cleveland Dr. R. C. Ellis.
Columbus Dr. J. F. Harrell.
Craven Dr. L. Duffy.
Cumberland Dr. J.VanceMcGougan.
Currituck No Board of Health.
Dare
Davidson Dr. John Thames.
Davie Dr. James McGuire.
Duplin Dr. F. H. Arthur.
Durham Dr. John M. Manning.
Edgecombe Dr. L. L. Staton.
Forsyth Dr. John Bynum.
Franklin Dr. E. S. Foster.
Gaston Dr. J. H. Jenkins.
Gates No Board of Health.
Graham No Board of Health.
Granville Dr. A. G. Coggeshall.
Greene Dr. Joseph E.Grimsley.
Guilford Dr. A. E. Ledbetter.
Halifax Dr. I. E. Green.
Harnett No Board of Health.
Haywood Dr. J. Howell Way.
Henderson Dr. J. G. Waldrop.
Hertford Dr. John W. Tayloe.
Hyde No Board of Health.
Iredell Dr. Henry F. Long.
Jackson Dr. William Self.
Johnston
29O BULLETIN OF THE NORTH CAROLINA BOARD OF HEALTH.
[You are asked to fill out and mail one of these forms to the Superintendent of Health
of your County on or before the third of each month, that he may use it in making his
report to the Secretary of the State Board]
Have any of the following diseases occurred in your practice during the month
just closed. If so, state number of cases.
Whooping-cough
Measles
Diphtheria
Scarlet Fever _
Typhoid Fever
Typhus Fever—
Yellow Fever _
Cholera
Pernicious Malarial Fever Small-pox
Hemorrhagic Malarial Fever Cerebro-spinal Meningitis
What have been the prevailing diseases in your practice ?
Has any epidemic occurred among domestic animals ? If so, what ?
What is the sanitary condition of your section, public and private?
General Remarks
—M. D.
.189 -N. C.
S94-5-23-9S-2300.
BULLETIN
OF THE
Jlorth Carolina Board of Health.
Published Monthly at the Office of Secretary of the Board, at Raleigh, N. C.
Geo. G. Thomas, M D., Pres., Wilmington.
s. Westray Battle, M. D.,..As.heville
W H. Hakrell, M. D., Williamston.
John Whitehead. M. D., Salisbury.
C. J. O'Hagan, M. D., Greenville.
J. D Spice r, M. D., Goldsboro.
J L. Nicholson, M. D. Rich lands.
A. W. Shaffer, San Eng., Raleigh.
RICHARD H. Lewis, M. D., Secretary and Treasurer, Raleigh.
Vol. XIlX MAY, 1898.
ANNUAL MEETING OF THE BOARD.
As required by law, the annual meet-ing
of the Board was held at the same
time and place as the State Medical So-ciety,
viz., Charlotte, May 3-4. Drs.
O'Hagan, Battle, Nicholson, Colonel
Shaffer and the Secretary were present.
At the business meeting, on the 3rd, in
the unavoidable absence of President
Thomas, Dr. O'Hagan was elected Presi-dent/;*'
tern. In addition to the routine
business, the report of the Engineer of
the Board on the public water supplies of
the State was read and discussed at con-siderable
length. Upon the conclusion
of the discussion the Secretary was or-dered
to devote one issue of The Bul-letin
to its publication, together with
the chemical and bacteriological analyses
of the samples sent in by him. It will
appear next month.
An inspection of all the public institu-tions
of the State, by committees to be
appointed by .the President, was ordered.
On Wednesday, as has been the cus-tom
for many years, the Board met in
conjoint session with the State Medical
Society, Dr. Battle in the chair.
The Secretary read his annual report.
The subject receiving the most atten-tion
in the discussions was vaccination,
quite a number participating. In ihe
course of it, Dr. Francis Duffy, President
of the Society, described a device for
dressing vaccinated arms, which struck
us as being very practical and convenient
—so much so that we feel it to be our
duty to describe it for the benefit of our
medical readers, as we hope they have
much good vaccination work ahead of
them. The device may be briefly de-scribed
as follows : A piece of rubber
adhesive plaster three or four inches
wide and long enough to go about two-thirds
around the vaccinated arm, with
tapes attached to each end. The planter
is applied to the arm with its centre op-posite
the sore, the tapes hanging loose.
At each end of the plaster a roll of ab-sorbent
cotton is laid on the skin in the
line of the arm just at the attachment of
the tapes, so as to lift them above the
skin. The dressing is then applied, and
the tapes tied over it to hold it in place.
In each subsequent dressing the only
thing to do is to untie the tapes, renew
the dressing and re-tie them. Dr. Duffy
stated that he had found it much more
292 BULLETIN OF THE NORTH CAROLINA BOARD OF HEALTH.
satisfactory than the usual vaccination
shields, and we could well believe him.
In connection with the subject of Na-tional
Quarantine, the following resolu-tion
was unanimously adopted:
Resolved, That the North Carolina
Board of Health and the Medical Society
of the State of North Carolina, in con-joint
session assembled, endorse the Caf-ferv
bill enlarging the powers of the U.
S. Marine Hospital Service, and respect-fully
request our Senators and Represen-tatives
in Congress to support the same.
SMALL-POX IN NORTH CAROLINA.
Only one case has been reported in
May up to date of this writing, lsth.
This is a negro " missionary preacher '' at
Statesville. The notification, by tele-graph,
was received on the 17th, and no
particulars as to isolation, vaccination,
etc., have cmne to hand, but we feel as-sured
that Superintendent Long will care-fullv
look after these.
PRESIDENT DUFFY ON PUBLIC HYGIENE.
We take much pleasure in presenting
to our readers that portion of the admir-able
presidential address of Dr. Francis
Duffy, delivered at the recent meeting of
the State Medical Society at Charlotte,
relating to the public health. He says :
It may be like the re-threshing of old
straw to refer to the importance of pub-lic
hygiene, and the necessity of procur-ing
legislation for the promotion of that
object, but as that sort of straw has
yielded so comparatively little of the
grain which it is capable of producing, I
am impressed that we should continue to
thresh. As far as we are concerned, I do
not feel that it is necessary to remind
this body of these things, much less to
offer instructions, but with the people in
general, as well as their legal representa-tives,
it is different. They have not yet
found out the best way to spend their
money with the medical profession to get
the best returns. With them the time-honored
function of the doctor is to ap-ply
remedies, to diseases, and according
to the law of supply and demand, the
physician usually equips himself for the
performance of that function, and by so-licitation
and practice grows in that direc-tion.
It is not my purpose to derogate
this part of the physician's work. The
world would be much poorer without the
legitimate use of opium, chloroform,
eocain. quinine, iodine, mercury and
other remedies. If the evil is upon us,
that which removes or mitigates it will
continue to be appreciated and sought,
but where cure can save its thousands,
prevention can save its tens of thousands,
and it is a crying necessity to-day that
this fact receive both a theoretical and
practical realization by the whole people.
Before we can hope to leaven the whole
lump of the b> dy politic, let the phy-sician
scrutinize himself and the field that
he occupies, to see how far he is the ex-ponent
of the true science, or to what
extent he typifies or justifies a recent car-toon
that represents nature and disease in
fierce combat, while the doctor comes up
blind-folded, and with his cudgel strikes
risrht and left, now striking the disease
and now the patient.
The history of the application of ther-apeutic
measures (drugs mainly) does
much to justify this cartoon. It is not
necessary to more than refer to the incan
tations and other absurdities of ignor-ance
and superstition which were in keep-ing
with the dark ages in which they were
practiced. Within the memory of men
of to-day, famishing fever patients have
been deprived of water by their mis-guided
attendants, who were governed by
tradition and custom, rather than by the
dictates of common sense and the unerr-ing
cravings of nature. Even the foul
air of the patient's room was carefully
confined by closing the doors and win--
dows, and perhaps his strength still more
reduced by copious blood-letting.
My mother related to mean experience
in her earlv life. Her father, living on
his plantation, was stricken with (ever,
and after some days or weeks of bleed-ing
and famishing he died. A number of
his negro slaves were also stricken and
under the same management went the
same way. One servant begged to be let
alone and not subjected to the treat-ment.
His wishes were gratified and he
alone recovered. I remember the old
man well. He lived to advanced age.
BULLETIN OF THE NORTH CAROLINA BOARD OF HEALTH. 293
Homeopath}- and a number of other
pathies, in spite of their absurdities, had
fruitful soil in which to grow. They
were less aggressive on the persons of the
suffering sick, and if they gave no aid,
were not so likely to hinder natural re-coveries,
and so the regular profession
looked on, learning from experience,
grew in knowledge, by its natural evolu-tion,
and became wiser than their critics.
But the medical millenium has not yet
come, nor are the days of mal-practice
past. Even among operative procedures,
the fads of gynecologists and the ex-ploits
of those seeking fame by startling
measures in other fields require con-stantly
to be challenged, to show cau-e
why they should not be discontinued. If
the nov ce takts up an optimistic modern
work on materia medica, and studies the
physiological effect of drugs and their
therapeutic application, he might easily
be impressed with the belief that drugs
could control every pathological process,
and remove every morbid condition.
Coupled with these studies, he is very
much surprised to find that works on
practice of medicine (perhaps especiallv
those of the scientific Germans ) will give
exhaustive descriptions of disease, path-ology,
etiology, clinical history, diagno-sis
and prognosis, but beyond general
reference to hygiene, nothing specific as
to the treatment. Tne fact of the lim-ited
power of drugs to work beneficial
changes begins to dawn upon him, and
that even those that are of undoubted
value are like edged tools, and require
careful handling. Even our compara-tively
harmless quinine, which so effect-ually
destroys the malarial plasmodium,
has been made to do its share of harm.
On no less authority than the German
professor, Leibermeister, 40 grains at a
dose have been given to typhoid patients.
Within recent years the coal tar antipy-retics
were hailed with delight. Fever
killers had come at last! A Baltimore
professor told his class that antipyrine
was what he had been praying for. I
think you will agree with me that more
patients than fevers have been killed by
them ; and these remedies are in rather
common use among the laity.
Not many days aa;o I visited a child to
whom the mother had administered a
dose of acetanilid before the cold stage
of an intermittent fever had disappeared.
Alarming symptoms followed. Another
case came under my notice, where a far-mer
had administered a dose of acetani-lid
under similar circumstances. The
child died, apparently from its effects.
Not many years ago, the doctrine was
promulgated that disease, a condition of
lowered vitality, required to be combat-ted
by copious administration of alco-holics.
This fascinating theorv had
many adherents and did much harm. In
the field of dietetio, we went from star-vation
to stuffing. Even to-day an Amer-ican
text-book advises that a tvphoid
fever patient may take as much as six
quarts of milk a day. a quantity that has
been shown by physiological experiment
to be one-third more than the full diges-tive
capacity of a healthy man, eating
nothing else and digesting all the day.
We have no infallible guides. Our rea-son
must challenge every theory, and our
experience prove all things, and hold fast
to that which is good.
But why this arraignment of a profes-sion,
which in the matter of education,
conscientiousness and faithfulness com-pare-!
favorably with any on earth. It is
tD lament that our most uncertain and
dangerous functions are most in demand ;
that millions ol dollars are paid by the peo-ple
for the practice of medicine as it is
being done, and as to some little extent
has been indicated in the foregoing pages,
while our best functions or capabilities
are dwarfed by disuse and neglect. The
public health officer would have to be a
missionary at his own expense, while a
premium is put on disease. This is not a
mere perverse and unnatural choice of
the people. They are as wise as we are,
and will seek their own good as they con-ceive
it to be. We are of them, and dif-fer
only as regards these matters in
knowledge.
If they, the masses of the people, knew
as much of the sources of the disease as
the educated better element of physicians,
who do you suppose would be in the van
of the procession to stamp it out? The
man who reaps a harvest when disease
runs riot, or the man who pays the bill.-?
That the people should become possessed
of this knowledge is the piime requisite,
for should we obtain such legislation as
in our judgment was all that was necessary
and such appropriation- aswould leave our
Board of Health unhampered in discharge
of their functions, the laws would be
largely inoperative if lacking in popular
2 94 BULLETIN OF THE NORTH CAROLINA BOARD OF HEALTH.
sympathy and support ; besides, many of
these things would depend on habits of
individuals, which legislation could not
control. It is to be, then, chiefly a mat-ter
of education; and how to accompliah
this, is the problem.
If the individual physician in his pro-fessional
and social contact with his cli-ents
sows the seed, if our Boards of Health,
local and State, continue and even im-prove
upon their good work, and if our
schools, from the lowest to the highest,
teach the rudiments of the science of
health, and unfold to the mind of the
pupil the necessity of expert work in the
prevention of disease, knowledge must
grow. And if our State Society, in its
organized capacity, with the courage of
its convictions, does not hesitate to urge
necessary legislation, they will have dis-charged
their dut)', and may soon accom-plish
much.
Tvphoid fever,which is perhaps entirely
ventable, causes the State the loss of
manv a victim and much treasure. Cur-rent
knowledge or opinion ascribes its
propagation almost entirely to intestinal
discharges of the infected. Prevention
would seem to be in easy reach, yet it
goes on. Personal observation leads me
to believe that disinfection of the dejec-tions
is not accomplished in one half the
cases. Man}- cases of continued fever are
not considered typhoid fever which are
most likely of that nature. I will not
discuss the subjt ct, but pass it by with
the recommendation that the dejections
of all fever patients be disinfected. The
pub'ic should be instructed to do so, even
where physicians are not employed, as
they often are not, and it may be a fit
subject for compulsory legislation. Our
Board of Health has done a good service-in
the matter of prevention of malarial
fevers by use of deep well and cistern
water. But a property managed cistern
is an exception. Infectious germs are
carried from the atmosphere or house-tops
to the cistern. Filters, often im-perfect,
remain unchanged until over-saturated.
They become thus the source
of infection. Tuberculosis continues to
be propagated by the expectoration of
the infected without hindrance, except
perhaps in one municipality in the State.
Milk is sold from any kind of cow which
will afford it. Diseased meats are sold
in the markets. Ice is imported from
impure sources and people believe that
freezing purifies it, which is true only to
a limited extent, and may be manufac-tured
from impure water. Any kind of
canned food is sold that any one will buy.
There is no check on adulteration or
fraud as to what the people eat or drink
or take as medicines, patent or proprie-tary,
save their own unskilled judgment,
warped or blinded by alluring advertise-ments
and unblushing false assertions.
The physician often finds that a patient
unable to pay him has raked up money
enough to pay an exorbitant price for
worthless medicines or appliances. Drug-gists
practise medicine. Spectacle ven-ders,
ignorant or unscrupulous, still prac-tice
this branch of the medical art,
though a medical college graduate has
first to pass our State Board. Danger-ous
drug habits or other evil conse-quences
arise from headache cures and
the like. Beverages (coca cola for in-stance)
sold from the soda fountains
should be subject to analysis and the peo-ple
advised, or the sale interdicted if nec-essary.
I refrain from further specific
references.
The doctor of the future will probably
differ more widely from the one of to-dav
than the doctor of to-day differs
from the one of the past. We know
something of him of the past and the
present, and that the tares have been
mixed with the wheat in varying propor-t
ons. With prophetic eye we may con-template
him of the future, but we know
not how far distant, or how near at hand.
The poet or philosopher may by inspira-tion
point the way, the scientist by ex-perimental
research may demonstrate.still
events occur only in the fulness of time
or that period in the evolution of the
human race under the sovereignty of God
when it is possible to achieve that which
before was not attainable, but thr sword
of the doctor (his weapons of %varfare on
disease or the diseased) will be changed
to the pruning-hook, which cuts away the
poisonous branches Lupon which grow
the deadly fruit.
In the propagation of the race, in the
construction of human habitations, in
clothing and in food, in labor and in rec-reation
there is a rational wisdom, and in
connection with these there should be
skilled advisers. If physic should be
thrown to the dogs, will the doctor's oc-cupation
be gone? Not when he has
proper surveilance over everything that
BULLETIN OF THE NORTH CAROLINA BOARD OF HEALTH. 295
affects the health of the people. In his
present status of equipment he could do
much more than he does or is permitted
to do, but when the new order of things
creates the demand, medical colleges will
not condone ignorance of chemistry and
physics, even as now imperfectly taught,
nor make side-shows of the microscope
and laboratory These stones, which are
well nigh rejected by the builders of med-ical
education, will become the heads pf
the corner. These things will be sine qua
non
.
North Carolina has been called the Rip
Van Winkle of States; still she has been
known to arouse from her lethargy. In
the matter of legislation regulating the
practice of medicine, she was ( through
the influence of our Society) in the van
of the procession. And in this historic
city (Mecklenburg County), May 20th,
1775, she sounded the bugle call as a pio-neer
of libertv. It is fitting that we
should here resolve to push still further
the lines of human progress.
REVIEW OF DISEASES FOR APRIL. 1898.
(SEVENTY-SEVEN COUNTIES REPORTING.)
Eighty-one counties have Superinten-dents
of Health.
Except in the case of the more conta-gious
and dangerous diseases, the Super-intendent
has, as a rule, to rely upon his
own information alone, since few physi-cians
can be induced to report cases of
non-contagious diseases to him.
Where the number of cases is not given,
or the prevalence of a disease otherwise
indicated, its mere presence in the county
is to be understood as reported.
For the month of April the follow-ing
diseases have been reported from the
counties named:
Measles — Alamance; Alexander, 1;
Beaufort, in all parts (100); Bertie; Bun-combe,
1 ; Catawba, many; Chowan, epi-demic
; Franklin, many; Haywood, ^:
Johnston ; Lincoln, 3; Martin, 2; Mont-gomery,
10; Pitt, widely prevalent in
southern part ; Randolph, 10; Robeson;
Rockingham, in all parts; Stokes, in all
parts. Wake, 19; Warren, several; Wash-ington,
2; Wilkes, 25; Wilson, 5; Yad-kin,
2; Yancey, a few—25 counti< s.
Mumps—Alamance; Jackson; Macon;
Mecklenburg; Union.
11 'hooping-cough—Chowan, epidemic;
Durham, 1; Granville; Greene, 50; Jack-son,
10; Mitchell, 40; Montgomery, 50;
New Hanover. 1; Onslow, 10; Randolph,
20; R.obeson; Wan en, several; Washing-ton,
70; Wayne, epidemic; _Wilkes, 15!
Yadkin, 12—16 counties.
Scarlatina—Buncombe, 1; mild, quar-antined,
recovered; Cumberland, 5 ; Rich-mond,
3.
Diphtheria—Jackson, 8.
Typhoid Fever—Alexander,!; Beau-fort.
3 ; Catawba, 2; Davidson, 1; Pitt,
Randolph; Robeson; Rowan; Sampson, a
few; Swain, 3; Union, 12—11 counties.
Malarial Fever—Columbus ; Gaston,
2; Sampson; Wilson.
Small-pox—Buncombe, 2.
Influenza— Mecklenburg; Transylva-nia.
Pneumonia — Mecklenburg; Orange;
Perquimans; Rutherford; Transylvauia;
Warren, Yadkin—7 counties.
Diarrheal Diseases—Cleveland; Gas-ton;
Hertford; Nash; Rutherford; Samp-son.
\'ar ice/la—Greene; Mecklenburg and
Wake.
Distemper in Horses—Lincoln.
Cholera in Hogs—Hertford; Macon.
No diseases of importance are reported
from Bladen, Burke, Cabarrus. Caldwell,
Cartaret, Chatham, Cherokee, Clay,
Edgecombe, Forsyth, Gates, Halifax,
Henderson, Iredell, McDowell, Madison,
New Hanover, Pasquotank, Pender, Per-son,
Polk, Surry and Watauga.
No reports have been received from
Anson, Craven, Duplin and Vance.
296 BULLETIN OF THE NORTH CAROLINA BOARD OF HEALTH.
Summary of Mortuary Reports for April.
1898 (Twenty-three Towns).
Only those towns from which certified
reports are received are included:
White. CoVd. Total.
Aggregate popula-tion
7 2 .439 55.S2I 128,260
Aggregate deaths . . 48 Si 129
Representing tem-porary
annual
death rate per
1,000 7-9 T 5-6 12.
1
Ca uses of Deo th
.
Typhoid fever 2 o 2
Malarial Fever. ... I 1 2
Whooping-cough..022
Measles o 1 1
Pneumonia 6 5 1
1
Consumption 9 19 28
Brain diseases 7 2 9
Heart diseases 2 5 7
Diarrhceal diseases 606
All other diseases . 1
5
42 57
Accident o 4 4
48 Si 129
Deaths under five
years 15 24 39
Still-born 1 19 20
BULLETIN OF THE NORTH CAROLINA BOARD OF HEALTH. 297
Mortuary Report for April, 1898.
Towns
298 BULLETIN OF THE NORTH CAROLINA BOARD OF HEALTH.
County Superintendents of Health.
Alamance Dr. J. K. Stockard.
Alexander Dr. T. F. Stevenson.
Alleghany
Anson Dr. E. vS. Ashe.
Ashe Dr. L. C. Gentry.
Beaufort Dr. D. T. Tayloe.
Bertie Dr. H. V. Dunstan.
Bladen Dr. Newton Robinson.
Brunswick Dr. D. B. McNeill.
Buncombe Dr. I. A. Harris.
Burke Dr. J. L. Laxton.
Cabarrus Dr. J. S. Lafferty.
Caldwell Dr. A. A. Kent.
Camden No Board of Health.
Carteret Dr. F. M. Clarke.
Caswell
Catawba Dr. F. L. Herman.
Chatham Dr. H. T. Chapin.
Cherokee Dr. S. C. Heighway.
Chowan Dr. R. H. Winborne.
Clav Dr. W. E. Sanderson.
Dr. R. C. Ellis.
Dr. J. F. Harrell.
Dr. L. Duffy.
. Dr. J.Vance McGougan.
No Board of Health.
Cleveland . . .
Columbus . .
Craven
Cumberland.
Currituck .
.
Dare
Davidson Dr. John Thames.
Davie Dr. James McGuire.
Duplin Dr. F. H. Arthur.
Durham Dr. John M. Manning.
Edgecombe Dr. L. L. Staton.
Forsyth Dr. John Bynum.
Franklin Dr. E. S. Foster.
Gaston Dr. J. H. Jenkins.
Gates Dr. R. C. Smith.
Graham No Board of Health.
Granville Dr. G. A. Coggeshall.
Greene Dr. Joseph E.Grimsley.
Guilford Dr. A. E. Ledbetter.
Halifax Dr. I. E. Green.
Harnett No Board of Health.
Haywood Dr. J. Howell Way.
Henderson Dr. J. G. Waldrop.
Hertford Dr. John W. Tayloe.
Hyde No Board of Health.
Iredell Dr. Henry F. Long.
Jackson Dr. William Self
.
Johnston ....
BULLETIN OF THE NORTH CAROLINA BOARD OF HEALTH. 299
[You are asked to rill out and mail one of these forms to rhe Superintendent of Health
of your County on or before the third of each month, that he mav use it in making his
report to the Secretary of the State Board]
Have any of the following diseases occurred in your practice during the month
just closed. If so, state number of cases.
Whooping-cough Typhoid Fever
Measles Typhus Fever ;
Diphtheria Yellow Fever
Scarlet Fever Cholera
Pernicious Malarial Fever — Small-pox
Hemorrhagic Malarial Fever Cerebro-spinal Meningitis
-
What have been the prevailing diseases in your practice ?
Has any epidemic occurred among domestic animals ? If so, what?
What is the sanitary condition of your section, public and private ?
Genera] Remarks
-M. I).
1S9 — N.C.
428-6-20-98-2400.
BULLETIN
OF THE
Itorth GaFolina Board of Health.
Published Monthly at the Office of Secretary of the Board, at Raleigh, Ar
. C.
Geo. G. Thomas, M. I)., Pres., Wilmington.
S. Westray Battle, M. D.,..Asheville.
W. H. Haerell, M. D., Williamston.
John Whitehead, M. D., ...Salisbury.
G. J. O'Hagax, M. D Greenville.
J. D Spicer, M. D Goldsboro.
J. L. NICHOLSON, M. D., Richlands.
A. \V. Shaffer. San Exg , Kaleigh.
RICHARD H. LEWIS, M. D., Secretary and Treasurer, Raleigh.
Vol. XIII. JUNE, 1898. No.
SMALLPOX IN NORTH CAROLINA.
Eleven cases reported in Statesville and
Belmont, a suburb thereof. All isolated
in pest hospital and eight about well.
Another case reported as present at Van-derborg's
Chapel. It is strictly quaran-tined.
There being a disposition on the part of
the people to break over the quarantine,
notwithstanding all the local physicians
were agreed as to the diagnosis, the Su-perintendent
of Health asked for an ex-pert
to be sent to back him up. In com-pliance
therewith we requested Surgeon
General Wyman, M. H. S, to send one.
Dr Wertenbaker was sent, and reports to
us that the outbreak is well managed by
the local authorities.
YELLOW FEVER.
We regret to note the recent restricted
outbreak of yellow fever in Mississippi.
The fears that owing to the mild winter
some of the germs of last summer might
be brought over seem to have been real-ized.
We shall watch the immediate fu-ture
with anxiety, but trust that it can be
kept within bounds.
THE PUBLIC WATER SUPPLIES OF THE
STATE.
At the annual meeting of the Board at
Morehead in June, 1897, "it was ordered
that the municipal water supples of the
State be examined chemically and bacte-riologically
during the current year; and
that the engineer of the Board be re-quested
at his convenience to collect,
pack and ship samples for the same, and
at the same time to make an inspection
and report on the various water works
and water sheds." Col. Shaffer having
carried out the above instructions, sub-mitted
his report to the recent meeting of
the Board in Charlotte—the first since
the completion of the work—and the Sec-retary
was ordered to publish it in the
Bulletin.
It may be remembered by some of our
readers that this work of systematically
investigating all the public water supplies
of the State was first undertaken in 1896,
and was limited to simply an analysis of
the water. While that examination was
very incomplete, owing to the extremely
small appropriation by the State, it un-doubtedly
had a good effect on the water
companies. We are all more particular if
12 BULLETIN OF THE NORTH CAROLINA BOARD OF HEALTH.
we know we are watched. Realizing this,
the Board felt that some of its little money
could not be put to a better use, and so
the action indicated above was taken.
The reader will understand, of course,
that we do not suppose that an annual in-spection
and analysis will make pure
water, but it will make for purer water by
causing the water companies themselves
to take a more active interest in the mat-ter.
Neither would any number of analy-ses
insure pure water, for the reason that
it must be already infected before the
pathogenic bacteria can be found. Fre-quent
inspections of the water shed, how-ever,
and thorough filtration would be
much more effective. It is far safer and
easier to prevent disease germs from get-ting
into the water than to get them out
after they have taken possession. And
inasmuch as a number of our supplies are
taken from small streams whose restricted
water sheds are inhabited, the danger of
infection is much greater than where the
origin of the supply is different. After a
careful consideration of the matter, we
have come to the conclusion that the best
thine water companies obtaining their
supply from such water sheds can do to
insure the purity of their water, is to em-ploy
some reliable man whose sole duty
it shall be to thoroughly patrol the water
shed, going over it and visiting every resi-dence
thereon at least twice a week, and
promptly reporting every case of fever or
diarrhoeal disease, that it may be immedi-ately
investigated and such precautions
taken as may be necessary. We are glad
to say that this suggestion made in a con-versation
with one of the owners has al-ready
been adopted by the Charlotte
Water Company. If this thorough and
continuous inspection should be supple-mented
by approved filtration, we be-lieve
that the danger of infection would
be reduced to a practical minimum. It is
apparent, we think, that it would be
clearly to the interest of the water com-panies,
for the occurrence of typhoid fe-ver
traceable to their water would reduce
their receipts far more than carrying out
the above suggestion for a number of
years. Besides, the effect of such careful
protection of the watei against infection
would give confidence to the people, and
would be immediately and continuously
beneficial to their business.
The reader of the report will doubtless
be struck with the high price charged for
water, especially to small consumers,
which, of course, includes all the poorer
classes. In several instances a minimum
consumption amounting to $12 per an-num
is required, which is practically pro-hibitory
to the poor. While no doubt
some of the companies find it a hard mat-ter
to "make buckle and tongue meet,"
this should not be. We have no control
over the price charged, but we feel it our
duty to say that high-priced water is not
in the interest of public health. Pure
water in abundance, at a price within the
reach of all, is one of the most powerful
agencies for promoting the health of any
community. It is for this reason that we
believe so strongly in municipal owner-ship.
We cannot expect those who have
invested their money in such enterprises
for the purpose of securing dividends to
look at the matter from the eleemosynary
point of view—they have a right both in
law and equity to make such charges as
will insure them a reasonable return on
their investment. But when the water
works are owned by the people as a whole
the object of the management will not be
dividends but health, comfort, beauty and
safety from fire. The general tendency is
towards municipal ownership, and we
trust that it will spread in North Caro-lina.
It pay=. Wilson owns its own
work and sells water at ten cents per
1.000 gallons at a profit.
It should be noted in connection with
BULLETIN OF THE NORTH CAROLINA BOARD OF HEALTH. 13
the chemical analyses that where the al-buminoid
ammonia is too high, that it is
nearly always due to vegetable matter in
the stream in the form of leaves, etc., and
that it is not dangerous in itself. In re-gard
to the bacteriological tests, it should
be said that while the}- are not as elabo-rate
and complete as they might be, they
are made by good men and are carried
far enough to show whether or not there
is reason to suspect the water of being in-fected
.
In conclusion, we wish to put ourself
on record as favoring the use of public
water supplies as against the water of
wells, provided the companies will con-scientiously
use every reasonable effort to
insure the purity of their supplies. The
water of the public supply may some-times
be dangerous, but that from wells
in closely-built cities and towns with sur-face
privies, and more especially cess-pools,
is much more apt to be so.
The chemical analyses were all made
for us without charge by the N. C. Agri-cultural
Experiment Station, and we de-sire
to make our acknowledgments to
Acting Director Withers for his valuable
aid in this respect.
The comments on all chemical analyses
are made by the chemist.
Report of Col. A. W. Shaffer, En-gineer
of The Board.
Goldsboro, August 3, 1897.
One sample taken from intake on Little
river at the power house, and one from
the tap in front of Hotel Kennon, on
Railroad street, both for bacteriological
analysis, taken, packed and delivered to
Dr. Anderson, of Wilson, in his presence.
Samples for chemical analysis have been
since procured by yourself.
This visit to Goldsboro has been fully
reported heretofore.
The following is the report referred to :
"I reached the city about noon, and
was glad to find awaiting me, the Presi-dent,
Dr. Geo. G. Thomas, and the Biol-ogist,
Dr. Anderson, Drs. Spicer and
Hill conferring with us cordially.
We visited the water works on Little
river in company with the mayor, and
found the works small, but filter working
well, and supply tinted with the juniper
and cypress, through which it passes, but
clear, and free from green scum, bad odor
or taste, which had been reported to ex-ist
there. We took samples from the in-take
and returned to the city ; took an-other
from the tap in front of Dr. Hill's
drug store, in the hotel building, and Dr.
Anderson packed both in ice and carried
them with him that night to Wilson.
Through the courtesy of the mayor we
were enabled to ride over the town and
view its water-shed and drainage. We
found no sewers, but we never saw a town
so well adapted by nature for efficient
sewering at a moderate expense—say
Waring's system. There is ample grade
and fall in every direction, with no rock
or hard subsoil to penetrate, and would
discharge into Neuse river within a mile
of the corporate limits, two to three
miles below the intake on Little river.
The water-bearing strata of Goldsboro
lies barely ten feet below the surface, and
in wet seasons the water in the wells
rises to within four to six feet of the sur-face.
The waste water of the town emp-ties
into shallow surface ditches, and is
liable to percolate through the sandy
crust to the wells, from which a large ma-jority
of the citizens of Goldsboro obtain
their water for all purposes.
I think that so tar as the health of the
town is concerned, there is greater dan-ger
than with no water works, because of
the lack of sewerage, to carry off the
waste.
Brifly stated, Goldsboro is situated upon
a plateau of open, sandy loam, elevated
about twenty feet above, and distant
14 BULLETIN OF THE NORTH CAROLINA BOARD OF HEALTH.
about one mile from Little river on the The chemical analysis indicates that
northwest, and Neuse river on the south, this is not a good water for drinking pur-
The water-bearing strata under the town poses.
averages eight to twelve feet below the bacteriological examination' by dr.
surface, and there are localities in which Anderson.
the well water can be reached from the Qne sampie ^ unfiltered, was collected
surface with a long-handled gourd. Hav- from the jntake at the river. This
ine no sewers, the city is drained by shal-sh
wed 300 ba teria to the C. C. of benign
low surface ditches, alternately wet and
form The other sample, filtered, was
dry from atmospheric causes; always collected from a faucet on Railroad
more or less charged with the waste and street and this contained only 53 bacteria
sewage of buildings, and the use of the to the c q The last sampi e represents
street and lawn taps connecting with the the water used Dv the city which is good.
river supply, the shallow wells beine the
common receptacle and reservoir of all. Wilson, Nov. 8, 1897.
If typhoid germs breed and multiply Two sampies taken from tap in drug
under the=e conditions, then Goldsboro store acjjoining Dr. Anderson on Main
is an ideal propagating ground, though street—one delivered personally to Dr.
the waters at the intake be as pure and Anderson and the other sent to Experi-limpi
i as those of Pi*on, Gihon or Hid- ment Nation at Raleigh.
ekel, that sprang from the garden of Visited power-house, intake and water-
God, shed with Dr. Anderson. These are
Works belong to private parties, who aDOut a mile from town. The works
sell water to small consumers at 40 cents have no filter and the town no sewerage,
per 1,000 meter gallons." The intake is ab<->ut one hundred yards
N. B.—Since the above report was from trie works, on the run of Toisnot
made the people of Goldsboro have voted swanlp) with a flow of water over the
bonds for sewering the city. £am ten inches deep and twelve feet
chemical analysis. wide, clear, but full of floating leaves,
Sample from Intake and tinted slightly by decaying vegeta-tion.
The canal draining the swamp is
Total solid matter -
and the area of
in solution 3.3 er. per U.S. gal. '
Hardness 1.4 deg. Clarke's sc. the swamp about one and a half square
Equiv. to cal. car. 0.33 gr. per U.S. gal. miles, with ever recurring living springs
Chlorine 0.33 gr. per U.S gal. aiong jt s margin—a very slight run cross-
Fr« e ammonia 106 parts per mil m thg intake If
Album'd ammonia. 0.170 parts per mil. * *•... ,_, , • „ „j
an open, dry ditch could be maintained
The chemical analysis indicates thit aroUnd the margin of the swamp, the
this is not a good water for drinking pur- banks f the canal and the run of the
poses. swamp cleared—say twelve feet wide on
Sample from Faucet in City. each side—and the run of the swamp
Total solid matter opened and kept clear from dead leaves,
in solution 3.3 gr. per U. S.gal. falling branches, trunks of rotten trees
Hardness 14 deg. Clarke's sc. an d water-grasses that obstruct the flow,
Equiv. to cal. car. 3.3 gr. per U.S. gal. they would have as near an ideal reser-
Chlorine. . . . 0.33 gr per U S gal. ^afford>
Free ammonia. ... 0.043 parts per mil. **
Album'd ammonia, 0.232 parts per mil. The works are owned and operated by
BULLETIN OF THE NORTH CAROLINA BOARD OF HEALTH. 1
5
the town; sell water to small consumers
at ten (10) cents per 1,000 meter gallons,
and realize a profit upon the cost of plant
and its operation.
CHEMICAL ANALYSIS.
Total solid matter
in solution 3.83 gr. per U.S. gal.
Hardness 1.7 deg. Clarke's sc.
Equiv. to cal. car. 0.58 gr. per U.S. gal.
Chlorine 0.33 gr. per U.S. gal.
Free ammonia . . 0.0449 parts per mil.
Album, ammonia 0.2155 parts per mil.
The high percentage of albuminoid
ammonia indicates vegetable contamina-tion.
BACTERIOLOGICAL EXAMINATION BY DR.
ANDERSON.
The bacteriological examination of
sample of water collected from the Wil-son
public water supply, November 10th
1S97, showed 150 bacteria to the C. C.
All tests used in making the examination
showed the water good.
Newbern, Nov. 10, 1*97-
Took two samples water from the run-ning
public hydrant at the corner of
Main street, near vhe Hotel Chattawka
;
one sent to Dr. Anderson at Wilson, the
other to Experiment Station at Raleigh.
Water derived from six bored, or ai tesian
wells ; no water-shed or filter. Works
owned and operated by private corpora-tion,
and water sold to small consumers
at 50 cents per 1,000 meter gallons, with
a minimum of 100 gallons per day.
CHEMICAL ANALYSIS.
Total solid mat-ter
in solution, 10.25 gr.per U.S. gal.
Hardness 10.01 deg. Clarke's sc.
Equi.tocal. car. 7.68 gr. per U.S gal.
Chlorine 0.5 gr. per U.S gal.
Free ammonia. . 0.0100 parts per mil.
Alb. ammonia.. . 0.020 parts per mil.
There is no indication of organic con-tamination.
BACTERIOLOGICAL EXAMINATION BY DR.
ANDERSON.
The sample of water received from the
Newbern public water supply, Novem-ber
10th, 1897, showed only S3 bacteria to
the C.C. in making a bacteriological ex-amination.
All tests used show this
water to be very good.
Wilmington, Nov. 11, 1897.
Took two samples water from tap in
Mr. Munds' drug store on Main street;
packed, addressed and deposited them in
express office, and withdrew them after
conference with and upon advice of the
President of the Board, to be retaken
upon the completion of the artesian well
now boring upon the site of the power-house,
or other production of acceptable
water.
Owing to the liability of infection by
the city sewage in the ebb and flow of the
tide, it is earnestly recommended that the
intake be removed above tide water in the
event of the failure of the artesian well
now boring.
The works are owned and operated by
private parties, and the water is sold to
small consumers at twenty cents per 1,000
meter gallons.
FayettevillE, Nov. 12, 1S97.
Two samples of water taken from the
running public hydrant at the corner of
Hotel Lafayette on Main street. One to
Dr. W. T. Pate, at Gibson Station, and
the other to the Experiment Station at
Raleigh.
This water is derived from the great
spring on Haymount Hill, and used for
drinking purposes chiefly. Other water
is taken from the run of Cross Creek, used
for general purposes, and for drinking
where Haymount water cannot be ob-tained.
No sample taken from Cross
Creek water.
The works are owned and operated by
i6 BULLETIN OF THE NORTH CAROLINA BOARD OF HEALTH.
private parties, and the water sold to
small consumers at twenty-five cents per
1,000 meter gallons, but not less than $1
per month.
CHEMICAL ANALYSIS.
Total solid matter
in solution 2.83 gr per U.S. gal.
Hardness 1.8 deg. Clarke's sc.
Equiv. to cal. car. 0.67 gr. per U.S. gal.
Chlorine 0.5 gr. per U.S. gal.
Free ammonia. . . . 0.061 parts per mil.
Alb. ammonia. . . . 0.0375 parts per mil.
The chemical examination shows no in-dication
of organic contamination.
BACTERIOLOGICAL EXAMINATION BY DR.
PATE.
The quantitative analysis gave 180 bac-teria
per cubic centimeter. The qualita-tive
tests showed no suspicious organisms.
Sample good.
Asheville, Nov. 19, 1897.
Two samples taken from tap in Ashe-ville
hotel. One to Dr. Albert Anderson.
at Wilson, the other to the Experiment
Station, Raleigh.
Through courtesy of Dr. Fletcher, vis
jted the filter within the city, the stand-pipe
and reservoir on Beaucatcher moun-tain,
and the power-house and intake five
miles out on the left bank of Swannanoa
river. This is the best plant in the State.
Four large filters are enclosed in brick
walls ; the reservoir is an abandoned rock
quarry, cleaned out and cemented, safe
against the intense cold that destroyed
the stand-pipe a few years ago, and the
power-house, dam and forebay are of
solid rock masonry. The water is con-ducted
to the city through two lines of
pipes, one ten and the other sixteen inches
in diameter, over two mountain spurs into
the stand-pipe and the reservoir.
This most expensive of the municipal
water works of the State is the property
of the city of Asheville, selling its water
to small consumers at fifteen cents per
1,000 meter gallons, and supplying the
street sprinkling, the sewer flushing, the
public, hydrants and the public fountains
free.
The only settlement on this water-shed
is at Black Mountain, sixteen miles away,
and very small.
CHEMICAL ANALYSIS.
Total solid matter
in solution ... . 2.16 gr. per U.S. gal.
Hardness 1.4 deg. Clarke's sc.
Equiv. to cal. car. 0.33 gr. per U.S. gal.
Chlorine 0.16 gr. per U.S. gal.
Free ammonia. . . . 0.013 parts per mil.
Alb. ammonia. . . . 0.0325 parts per mil.
A very pure water.
BACTERIOLOGICAL EXAMINATION BY DR.
ANDERSON.
The sample from the Asheville public
water supply was received November 20,
1897. In the bacteriological analysis of
this water no harmful bacteria were
found.
Charlotte, Nov. 22, 1S97.
Took two samples water from the run-ning
tap at Van Ness' grocery on Nnrth
Tryon street. One to Dr. W. T. Pate,
Gibson Station, the other to Experiment
Station, Raleigh.
By courtesy of Dr. Brevard, joint owner
with Mr. Eli Springs, I visited the power-houses,
reservoirs and part of the water-shed.
The latter consists largely of culti-vated
land. Not a favorable water-shed
for first-class water without thorough fil-tration.
There are. however, four filters
in use. The supply is derived from two
streams. Both average about one and a
half miles from the principal square in
town at the intersection of Trade and
Tryon streets. Both are conducted to a
settling basin near the power-house, from
which the water is conveyed to the filters.
This plant is owned and operated by
private parties, and water is sold to small
BULLETIN OF THE NORTH CAROLINA BOARD OF HEALTH. I
J
consumers at fifty cents per 1,000 meter
gallons. There exists an inchoate con-tract
for the sale of the plant to the city.
Note.—The management proposes to
reduce the rent to private consumers.
CHEMICAL ANALYSIS.
Total solid matter
in solution 5.91 gr. per U.S. gal.
Hardness 3.8 deg. Clarke's sc.
Equiv. to cal. car. 2.33 gr. per U.S. gal.
Chlorine 0.416 gr. per U.S. gal.
Freeammonia 0.36 parts per mil.
Alb. ammonia 0.1877 parts per mil.
The chemical analysis indicates vege-table
organic contamination.
BACTERIOLOGICAL EXAMINATION BY DR.
PATE.
The quantitative examination gave 425
bacteria to the cubic centimeter. This
sample forms gas in both glucose and lac-tose
bouillon, but I did not succeed in iso-lating
the fermenting bacteria.
SECOND BACTERIOLOGICAL EXAMINA-TION
MADE FOR WATER COMPANY
BY DR. PATE.
I have the honor to report as follows on
sample of water sent me from the public
water supply of Charlotte June 2, 189S
:
Sample shipped without ice.
It is clear—no sediment.
Contains only 120 bacteria to the cubic
centimeter of water. No fermentation in
lactose or glucose bouillon, even after sev-eral
days' growth.
This analysis indicates a safe drinking
water.
Concord, Nov. 23, 1S97.
Two samples of water taken from tap
at Marsh's drug store in presence of May-or
Crowell—one to Dr. W. T. Pate at
Gibson Station, the other to Experiment
Station at Raleigh.
Visited power-houses (two—both inside
city) with Mayor Crowell. The city is
built upon the crest of a long ridge, and
the supply of one station is taken from
the Reed Gold Mine shaft on one water-shed,
and the other from surface springs
on the opposite side, both very exactly
on the water-shed of the town. At the
first I found a pond of perhaps an eighth
of an acre, about a hundred feet above
the shaft, the overflow passing the station
within ten or twelve feet. On the other
water-shed, directly opposite, was the
other power-house, beside a walled and
covered spring.
The power-house contained a small
Worthington pumping engine, furnishing
power to run the pump and the electric
light plant of the town.
The Concord plant is owned and oper-ated
by a private party ; has a stand-pipe,
but no reservoir or filter, and the water is
sold to small consumers at 50 cents per
1,000 meter gallons.
CHEMICAL ANALYSIS.
Total solid matter
in solution 9.66 gr. per U.S gal.
Hardness 6.1 deg. Clarke's sc.
Equi. to cal. car. 4.25 gr. per U.S. gal.
Chlorine 1.16 gr. per U.S. gal.
Free ammonia . . 0.0449 parts per mil.
Album, ammonia, 0.05 parts per mil.
The chemical analysis does not show
any indications of organic contamination.
BACTERIOLOGICAL EXAMINATION BY DR.
PATE.
The quantitative examination gave 350
bacteria to the C. C. This water fer-ments
both glucose and lactose at 42 de-grees
in 36 hours. Quantity of bacteria
low—quality suspicious.
SECOND INSPECTION.
Concord, May 5, 1898.
I have the honor to report that pursuant
to the direction of the Board, made at
Charlotte conference on the 4th inst, I
visited Concord, N. C, and took new
l8 BULLETIN OF THE NORTH CAROLINA BOARD OF HEALTH.
samples of the municipal water, one for
the North Carolina Experiment Station,
at Raleigh, the other for Dr. W. T. Pate,
Biologist, Gibson, N. C, forwarding same
to each on the 5th inst.
I also visited and carefully inspected
the pump-houses and water-sheds of the
two stations, from which ihe water is ob-tained,
in company with Mayor Crowell
and the owner, Mr. F"etzer.
I found the ground about the walled
spring, had been raised about the
spring and graded off so as to make a
water-shed of about fifty (50) feet all
around it, and the surface was clear and
free from grass and weeds, but not in-closed.
Some additional machinery, of
an improved pattern—mostly electrical
—
had been placed in the power-house, but
no closet or stables had been removed
from the water-shed. Mayor stated,
however, that an ordinance removing
them to go into effect June 1st, had been
passed.
At the station on the opposite side of
the ridge on which the town stands,
known as the Reed Gold Mine Shaft Sta-tion,
I found the pump and connecting
pipes repaired and the pond freshly
drawn off. Another dam had been con-structed
across the run of the spring about
two hundred and fifty (250) feet above
the shaft- covering an area of about
3, coo feet—the overflow of which was
carried by a side-hill ditch to a wooden
box receptacle about fifty (50) feet from
the power-house, to be utilized for street
sprinkling, the sprinklers taking it di-rect
from the box.
The water-shed of this station is exactly
as I found it in November last—barring
the change of the pond. No closets or
stables have been removed. All of the
stables, and most of the closets discharge
upon the surface, but others discharge in
unwalled and uncemented pits and "old
wells," the latter of which are presumed
to connect directly with the water-bearing
strata within a radius of three hundred
yards of the pumping stations.
Mayor Crowell is deeply intetested in a
plentiful supply of pure wuter and a
limited sewerage within the financial ca-pacity
of the town. He afforded me
ever}' possible facility for inspection and
stated that the town council had lately
adopted an ordinance for the removal of
the closets and stables from the water-shed,
and assured me that if not rescinded
at a subsequent meeting, he would see
that the pits and vaults, after cleaning,
should be well limed before filling, but
the measure had met strong opposition,
and there was danger of a reconsideration
and rescinding of the ordinance before it
goes into effect on June 1, 1898. I saw
and conversed with some of the members
of the town council, and gathered from
their remarks that while all wanted pure
water and plenty of it, they were disin-clined
to credit the contamination theory,
and feared a "job," by which oppressive
taxes would be inflicted without corres-ponding
benefits. The wells on the di-viding
ridge are about forty feet in depth.
How they will cleanse and purify those
used for closet vaults, or whether they
will fill them up without cleaning, or
continue their use as heretofore—is yet an
unsolved problem. I regret to have to
state that the situation at Concord is not
greatly improved from the situation of
my November report, and I doubt
whether it will be greatly improved until
the water supply is taken from a source
above and beyond the town limits. The
mayor assured me that such a source ex-isted
about two miles out, with ample
supply for many years of rapid annual in-crease.
BULLETIN OF THF NORTH CAROLINA BOARD OF HEALTH. 19
CHEMICAL ANALYSIS.
Total solid matter
in solution .... 9.58 gr. per U.S. gal.
Hardness 3.6 deg. Clarke's sc.
Equi. to eal. car. 2.16 gr. per U.S. gal.
Chlorine o 79 gr. per U.S. gal.
Free ammonia . . 0.0073 parts per mil.
Album, ammonia, 0.0175 parts per mil.
A very pure water.
BACTERIOLOGICAL EXAMINATION BY DR.
PATE.
Sample of water collected may 5th,
1898, by A. W. Shaffer, S. E., from tap at
Johnson's drug store, Concord, N. C.
This sample contains only 92 bacteria to
the C. C. of water. No fei mentation in
lactose or glucose bouillon in 4S houis.
This indicates fair drinking .water, and
is by far the best sample that we have
had from this supply.
Salisbury, Nov. 24, 1897.
Took two samples water from flowing
hydrant of E. K. James, on Inniss street.
One to Dr. Albert Anderson, at Wilson,
the other to Experiment Station, Raleigh.
Water derived from Cane creek, rising
about six miles above town and flowing
along the base of Dunn's mountain, from
which a large part of its water comes.
Water-shed, cleared land on one side and
mountain growth on the other. No resi-dential
obstructions.
Power-house and intake two miles out;
stand-pipe in town; no sewerage; pump
run by Worthington engine; no filter; all
in good condition. E. B. Neave, Super-intendent.
Plant owned and operated by private
parties, and water sold to small consumers
at thirty cents per 1,000 meter gallons.
chemical analysis.
Total solid matter
in solution 9. 16 gr. per U.S. gal.
Hardness 3.8 deg. Clarke's sc.
Equiv. to cal. car 2.33 gr. per U.S. gal.
Chlorine 1.66 gr. per U.S. gal.
Free ammonia. . . . o 0566 parts per mil.
Alb. ammonia. . . . 0.0725 parts per mil.
The chemical analysis does not give any
indications of organic contamination.
bacteriological examination by dr.
anderson
In the bacteriological analysis of sam-ple
of water sent from Salisbury, received
on the 26th of November, there were re-vealed
some bacteria of a suspicious na-ture.
There were 1S0 bacteria to the cu-bic
centimeter.
Greensboro, Nov. 25, 1S97.
Took two samples water from running
tap at Holton's drug store in Hotel
McAdoo building on Main street. One
sent to Dr. Albert Anderson, at Wilson,
the other to the Experiment Station,
Raleigh.
Thanksgiving Day; everybody gone a
birding; did not go to plant or water-shed.
Couldn't find anybody who knew any-thing
about it.
Plant owned and operated by private
parties, and water sold to the small con-sumers
at forty cents per 1,000 meter gal-lons.
CHEMICAL ANALYSIS.
Total solid matter
in solution 5.66 gr. per U.S. gal.
Hardness 3.4 deg. Clarke' ssc.
Equiv. to cal. car. 2.0 gr. perU.S gal.
Chlorine 0.25 gr. per U.S. gal.
Free ammonia. . . . 0.0126 parts per mil.
Alb. ammonia . . 0.0737 parts per mil.
The chemical analysis does not give any
indication of organic contamination.
BACTERIOLOGICAL EXAMINATION BY DR.
ANDERSON.
On November 26th I received sample of
water from the Greensboro public water
supply. The bacteriological analysis
showed 150 bacteria to the cubic centime-ter.
This water is good.
Winston, Nov. 26, 1897.
Took two samples from public hydrant
in City Hall—one sent to Dr. YV. T. Pate,
20 BULLETIN OF THE NORTH CAROLINA BOARD OF HEALTH.
Gibson Station ; the other to Experiment
Station, Raleigh.
Supply derived from two springs. No
water-shed ; no filter and no sewerage.
Plant owned and operated by private
parties and water sold to small consumers
at 40 cents per 1,000 meter gallons. Rained
all day. No ice accessible.
CHEMICAL ANALYSIS.
Total solid matter
in solution. . . . 4.0S gr. per U. S gal.
Hardness 2.1 deg. Clarke's sc.
Equi. to cal. car. 0.91 gr. per U.S. gal.
Chlorine 0.766 gr. per U.S. gal.
Free ammonia . . 0.0233 parts per mil.
Album, ammonia, 0.0435 parts per mil.
The chemical analysis gives no indica-tion
of contamination.
BACTERIOLOGICAL EXAMINATION BR DR.
PATE.
Shipped without ice. The quantitative
examination gave 880 bacteria to the cubic
centimeter.
The qualitative examination reveals no
suspicious bacteria.
Salem, Nov. 26, 1897.
Took two samples water from tap at
Dr. Shaffner's drug store, on Main street
—one for Dr. W. T. Pate at Gibson, the
other to Experiment Station, Raleigh.
Water supply derived from springs in
southwest part of town.
No water-shed, no filters and no sewer-age.
Plant owned and operated by private
parties, and water sold to the small con-sumers
at 50 cents per 1,000 meter gal-lons.
Rained all day.
No ice accessible for bacteriological
specimen.
chemical analysis.
Total solid matter
in solution 5.08 gr. per U S. gal.
Hardness 1.9 deg. Clarke's sc.
Equi. to cal. car. 0.78 gr. per U.S. gal.
Chlorine. 1.25 gr. per U S. gal.
Free ammonia .. 0.24 parts per mil.
Album, ammonia, 0.1935 parts per mil.
The chemical analysis indicates that
this water is very dangerous. There
seems to be contamination from sewage.
BACTERIOLOGICAL EXAMINATION BY DR.
PATE.
The quantitative examination gave 1360
bacteria per cubic centimeter. This sam-ple
was sent by express without ice.
The qualitative examination gave no
indication of the presence of suspicious
organism.
As soon as the attention of the manage-ment
of the Salem Water Company was
called to the report of the State Chemist
on their water, they expressed their in-ability
to explain the apparent condition
of the water, and at once asked that four
new analyses, representing the four sources
of supply, be made. This was done, but
all four samples turned out chemically
excellent water. The apparent contami-nation
of the first sample has never been
explained. The following are the sup-plementary
analyses :
Total solid matter
in solution 2.92 gr. per U. S. gal.
Hardness .... 2.5 deg Clarke's sc.
Equi. to cal. car. 1.25 gr. per U. S. gal.
Chlorine 0.46 gr. perU. S. gal.
Free ammonia . . 0.051 parts per mil.
Album, ammonia, 0.050 parts per mil.
This sample shows no indication of or-ganic
contamination.
Total solid matter
in solution... 3.25 gr. perU.S gal.
Hardness 3.3 deg. Clarke's sc.
Equi. to cal. car. 1.92 gr. per U.S. gal.
Chlorine 0.67 gr. per U.S. gal.
Free ammonia.. . 0.0316 parts per mil.
Album, ammonia, 0.0500 parts per mil.
This sample shows no indication of or-ganic
contamination.
Total solid matter
in solution 3.17 gr. per U.S. gal.
Hardness 2.3 deg. Clarke's sc.
Equi. to cal. car. 1.08 gr. per U.S. gal.
Chlorine 0.25 gr. per U.S. gal.
Free ammonia.. . 0.0500 parts per mil.
Album, ammonia, 0.0487 parts per mil.
BULLETIN OF THE NORTH CAROLINA BOARD OF HEALTH. 21
This sample shows no indication of or-ganic
contamination.
Total solid matter
in solution 1.17 gr. per U.S. gal.
Hardness 1.8 deg. Clarke's sc.
Equi. to cal. car. 0.67 gr. per U.S. gal.
Chlorine 0.208 gr. per U.S. gal.
Free ammonia... . 0.044 parts per mil.
Album, ammonia, 0.0312 parts per mil.
This sample shows no evidence of or-ganic
contamination.
Durham, December 2, 1897.
Took two samples water from flowing
public hydrant, corner Cochrane and
Main streets. One to Dr. Albert Ander-son,
Wilson, the other to Experiment Sta-tion,
Raleigh.
Water supply taken from a stream nine
miles out, at its junction with Eno river.
Reservoir five miles out. Filter and sew-erage
here. Did not visit water-shed, as
it would consume another day.
Works owned and operated by private
parties, who sell water to small consumers
at twenty-five cents per 1,000 meter gal-lons,
or $3 per quarter with privilege of
12,000 gallons.
CHEMICAL ANALYSIS.
Total solid matter
in solution 3.67 gr. per U.S. gal.
Hardness 1.9 deg. Clarke's sc.
Equiv. to cal. car.. 0.75 gr. per U.S. gal.
Chlorine 0.275 gr- per U.S. gal.
Free ammonia 0.173 parts per mil.
Alb. ammonia .... 0.0505 parts per mil.
While the chemical analysis will not
condemn this water, it places it under sus-picion
of being contaminated with organic
matter.
BACTERIOLOGICAL EXAMINATION BY DR.
ALEXANDER.
There were 316 bacteria to the cubic
centimeter found in sample of water from
Durham public water supply, received and
put in culture December 3, 1897. The
water is fairly good.
Henderson. December 3, 1897.
Took two samples water from running
public hydrant on public square. One
sent to Dr. W. T. Pate, Gibson Station,
the other to Experiment Station, Raleigh.
Water taken from wells; no water-shed,
no filter and no sewerage.
Plant owned and operated by private
parties, and water sold to small consumers
at forty cents per 1,000 gallons meter
measure.
CHEMICAL ANALYSIS.
Total solid matter
in solution 3.25 gr. per U.S. gal.
Hardness 1.5 deg. Clarke's sc.
Equiv. to cal. car.. 0.42 gr. per U.S. gal.
Chlorine 0.25 gr. per U.S. gal.
Free ammonia. . . . 0.067 parts per mil.
Alb. ammonia. . . . 0.02037 parts per mil.
BACTERIOLOGICAL EXAMINATION BY DR.
PATE.
The quantitative examination gave 184
bacteria per cubic centimeter. The quali-tative
tests indicate safe drinking water.
Raleigh, December 7, 1897.
Two samples water taken from running
public hydrant in front of Metropolitan
Hall on Fayetteville street. One to Dr.
Albert Anderson, at Wilson, the other de-livered
in person to Experiment Station,
Raleigh.
Water supply taken from Walnut creek,
one mile south of city. Intake a mile
above, and a fourth of a mile above Rham-katte
road. Stream rises at Cary, eight
miles west of city. Water-shed visited,
inspected and fully reported on hereto-fore.
Condemned Yates dam still domi-nates
the waters. The company filter
their water, and the city is sewered.
Plant owned and operated by private
parties, who sell water to the small con-sumers
at forty cents per 1,000 meter gal-
22 BULLETIN OF THE NORTH CAROLINA BOARD OF HEALTH.
Ions, conditioned that it amount to $12
per annum, or 30,000 gallons per annum.
DETAILED REPORT OX WATER-SHED.
'
' I have the honor to report upon the
water-shed of the Raleigh water com-pany,
visited and inspected in company
with Dr. James McKee, Superintendent of
Health of the city; W. M. Russ, Mayor,
and Alex. M. McPheeters on the part of
the company, on the 24th inst. Com-mencing
at Cary, we found two open, un-boxed
privies on the bank of the main
ditch, and a pig-pen on another, the con-tents
of the latter flowing directly into the
main ditch at a distance of about 200 feet.
The main ditch contained a very slight
run of water, the product of a heavy
shower the previous night. There is no
living tributary at Cary, the ditch carry-ing
no water except surface water during,
and a few hours after, a storm—twenty-four
hours after which it is as " dry '
' as
the town ordinance. The first evidence
of a living stream appears about a mile
below the town.
We found all the streams running
muddy water from the rains of the pre-vious
night, until we reached the Hugh
Campbell spring branch, a bold, crystal
stream flowing from two fine springs on
the place.
'• The water-shed from Cary to Raleigh is
largely covered and protected by a natural
growth of forest and hedge, briars, cane
and shrub, and we found little to criticise
until we reached the "Little Yates
Mill," of L. D. Castlebury, on the Avent
Ferry road in Swift Creek township. The
dam of this mill backs water over five to
six acres, filled with mud and decom-posed
vegetation, with a rank growth of
grass, reeds, shrubs and weeds. As the
water is very shallow and the mud very
deep the site can be of no considerable
value for mill purposes, and afforded no
evidence of late use. Such a deposit in
the main run of the water supply must of
necessity contaminate the water that flows
from that point, creating a nuisance that
ought to be abated if possible.
" I am informed by Dr. McKee that this
dam was reported detrimental to the
health of the people of Raleigh and de-clared
to be a nuisance in December,
1S95. I have since found such report and
declaration, bearing date December 21,
1895, and signed by him officially as Su-perintendent
of Health of the city of
Raleigh, and the signature of Dr.
P. E. Hines, preceded by the fol-lowing:
' / endorse the above recom-mrndation.''
" The intake of the company is situated
upon the Grimes farm above the bridge
on the Rhamkatte road about a mile
southwest of the corporate limits of the
city. The surplus water flows over a nat-ural
ledge of gneissoid granite brought to
a dead level so as to carry off all floating
foreign matter at every point, airways pro-vided
it first escape the wide mouth of the
intake, set in the current and facing up
stream, like a saurian bobbing for flies. A
proper adjustment of this intake would
greatly relieve the filter at the pump-house,
and remove an ever-present source
of adverse criticism.''
CHEMICAL ANALYSIS.
Total solid matter
in solution 4.58 gr. per U.S. gal.
Hardness 2.1 ueg. Clarke's sc.
Equiv. to cal. car. 0.92 gr. per U.S. gal.
Chlorine 0.30 gr. per U.S. gal.
Free ammonia ...0.031 parts per mil.
Alb. ammonia. . . . 0.0787 parts per mil.
The chemical aualysis shows no indica-tion
of contamination from organic mat-ter.
BACTERIOLOGICAL EXAMINATION BY DR.
ANDERSON.
I found 240 bacteria to the cubic centi-meter
in sample from the Raleigh public
BULLETIN OF THE NORTH CAROLINA BOARD OF HEALTH. 23
water supply, some of which were of a
suspicious nature.
The order of the State Board of Health
is executed. All which is respectfully
submitted. A. W. SHAFFER, 5. E.
REVIEW OF DISEASES FOR MAY. 1898.
(SEVENTY-SIX COUNTIES REPORTING.)
Eighty-four counties have Superinten-dents
of Health.
Except in the case of the more conta-gious
and dangerous diseases, the Super-intendent
has, as a rule, to rely upon his
own information alone, since few physi-cians
can be induced to report cases of
non-contagious diseases to him.
Where the number of cases is not given,
or the prevalence of a disease otherwise
indicated, its mere presence in the count}'
is to be understood as reported.
For the month of May the follow-ing
diseases have been reported from the
counties named:
Measles.—Alexander, 7 ; Ashe, 4
;
Beaufort, 75 ; Buncombe, 1 ; Catawba,
numerous ; Chowan, many ; Davidson, 5 ;
Forsyth, in all parts ; Harnett, epidemic
in one section ; Johnston ; Moore, 75 ;
Orange, 1 ; Pitt ; Rockingham, a few ;
Vance, 4 ; Wake, 4 ; Warren, several ;
Washington, 3 ; Wayne, 6 ; Wilkes, 100
—
20 counties.
Whooping-Cough.—Ashe, 3 ; Chowan,
many ; Durham, some ; Granville ; Har-nett,
a few ; Nash, a few ; Onslow, 10 ;
Orange, a few ; Robeson ; Warren, sev-eral
; Washington, 40 ; Wilkes, 25 ; Yad-kin,
12—13 counties.
Scarlatina.—Cumberland, 3 ; Har-nett,
2 ; New Hanover, 7 ; Richmond, 3 ;
Diphtheria.—McDowell, 1 ; Macon, 1;
Typhoid Fever.—Alexander, 2 ; Beau-fort,
1 ; Buncombe, 2 ; Chowan, several ;
Cleveland, 2 ; Columbus, 1 ; Davidson, 1 ;
Gaston, several ; Greene, 2 ; Iredell, 1
;
Jackson, 4 ; McDowell, 2 ; Macon, 4 ;
Mecklenburg, 8 ; Mitchell, 4 ; Nash, 1
; New Hanover, 4 ; Onslow, 2 ; Perquimans,
a few ; Person, 2 ; Pitt, a few ; Rocking-ham,
1; Sampson, a few; Union, 10;
Wake, 1 ; Wautauga ; Wilkes, 1 ; Yadkin,
1—2.8 counties.
Malarial Fever.—Catawba ; Cleve-land,
4 ; Columbus, 4 ;Halifax ; Harnett ;
Jones ; Mecklenburg ; New Hanover, in
all parts ; Onslow ; Person ; Polk, a little ;
Robeson ; Sampson ; Vance ; Warren and
Wilson, in all parts—16 counties.
Malarial Fever, P e r n i c i o u s.—
Jones, 1.
Malarial Fever, Hemorrhagic.—
Cumberland, 1
; Jones, 1.
Mumps.—Clay ; Sampson ; Wayne.
Diarrhceal Diseases, including Dys-entery.
Alamance, in some neighbor-hoods,
local ; Bertie, local ; Bladen, local
Burke, throughout the county, general
Caldwell, a few cases ; Chatham, local
Cherokee, general ; Chowan, general
Cleveland, general ; Columbus, local
Cumberland, general ; Davidson ; Frank-lin,
general; Gaston, a few cases ; Gates,
local ; Greene, general ; Guilford, gener-al
; Halifax, general ; Harnett ; Hender-son,
general; Hertford, local; Iredell,
general ; Jones ; Lincoln, general ; Mc-
Dowell ; Macon, general ; Madison, local ;
Martin, general; Mecklenburg; Nash,
general ; Northampton, local ; Pasquo-tank,
in children, local ; Person, local .
Robeson, local ; Rockingham, general ;
Sampon, general ; Stokes, general ; Surry,
general ; Transylvania, local ; Union, in
some portions, general ; Warren, general ;
Yadkin, local—42 counties.
Influenza.—Jackson ; Northampton ;
Vance.
Pneumonia.—Gaston ; Jackson.
Smallpox.—Iredell, 8; Wilson, 1.
Cholera in Hogs.—Bertie ; Onslow ;
Wilkes.
Cholera, in Chickens.— Harnett.
Distemper, in Horses.—ciav.
24 BULLETIN OF THE NORTH CAROLINA BOARD OF HEALTH.
Roup, in Chickens.—Clay.
No diseases of importance are reported
from Cabarrus, Carteret, Edgecombe,
Haywood, Pender, Polk,Swain and Yancy.
No reports have been received from the
following counties having Superintend-ents
of Health : Anson, Brunswick, Cra-ven,
Duplin and Rowan.
Summary of Mortuary Reports for May
1898 (Twenty-two Towns).
Only those towns from which certified
reports are received are included:
White. CoVd. Total.
Aggregate popula-tion
67,789 53.621 121,410
Aggregate deaths . . 75 94 ^9
Representing tem-porary
annual
death rate per
1,000 13.3 21.0 16.7
Causes of Death
.
Typhoid fever o 2 2
Malarial Fever. ... o 5 5
Whooping-cough..011 Measles o 2 2
Pneumonia 1 4 5
Consumption 7 6 13
Brain diseases 6 5 11
Heart diseases.- ... . 4 9 13
Neurotic diseases .112
Diarrhceal diseases
.
14 10 24
All other diseases . . 40 49 SS
Accident 1 1 2
Suicide 1 o 1
75 94 169
Deaths under five
years 24 37 61
Still-born 6 15 21
BULLETIN OF THE NORTH CAROLINA BOARD OF HEALTH.
Mortuary Report for May, 1898.
25
Towns
26 BULLETIN OF THE NORTH CAROLINA BOARD OF HEALTH.
County Superintendents of Health.
Alamance Dr. J. K. Stockard.
Alexander Dr. T. F. Stevenson.
Alleghany
Anson Dr. E. S. Ashe.
Ashe Dr. L. C. Gentry.
Beaufort Dr. D. T. Tayloe.
Bertie Dr. H. V. Dunstan.
Bladen Dr. Newton Robinson.
Brunswick Dr. D. B. McNeill.
Buncombe Dr. I. A. Harris.
Burke Dr. J. L. Laxton.
Cabarrus Dr. J. S. Lafferty.
Caldwell Dr. A. A. Kent.
Camden No Board of Health.
Carteret Dr. F. INI. Clarke.
Caswell
Catawba Dr. D. M. Moser.
Chatham Dr. H. T. Chapin.
Cherokee Dr. S. C. Heighway.
Chowan Dr. R. H. Winborne.
Clay Dr. W. E. Sanderson.
Cleveland Dr. R. C. Ellis.
Columbus Dr. J. F. Harrell.
Craven Dr. L. Duffy.
Cumberland Dr. J.Vance McGougan.
Currituck No Board of Health.
Dare
Davidson Dr. John Thames.
Davie Dr. James McGuire.
Duplin Dr. F. H. Arthur.
Durham Dr. John M. Manning. •
Edgecombe Dr. L. L. Staton.
Forsyth Dr. John Bynum.
Franklin Dr. E. S. Foster.
Gaston Dr. J. H. Jenkins.
Gates Dr. R. C. Smith.
Graham No Board of Health.
Granville Dr. G. A. Coggeshall.
Greene Dr. Joseph E.Grimsley.
Guilford Dr. A. E. Ledbetter.
Halifax Dr. I. E. Green.
Harnett Dr. O. L. Denning.
Haywood Dr. J. Howell Way.
Henderson Dr. J. G. Waldrop.
Hertford Dr. John W. Tayloe.
Hyde No Board of Health.
Iredell Dr. Henry F. Long.
Jackson Dr. William Self.
Johnston
BULLETIN OF THE NORTH CAROLINA BOARD OF HEALTH. 27
[You are asked to fill out and mail one of these forms to the Superintendent of Health
of your County on or before the third of each month, that he may use it in making his
report to the Secretary of the State Board]
Have any of the following diseases occurred in your practice during the month
just closed. If so, state number of cases.
Whooping-cough— Typhoid Fever
Measles Typhus Fever
Diphtheria Yellow Fever
Scarlet Fever Cholera
Pernicious Malarial Fever Small-pox
Hemorrhagic Malarial Fever Cerebro-spinal Meningitis
-
What have been the prevailing diseases in your practice ?
Has any epidemic occurred among domestic animals? If so, what?
What is the sanitary condition of your section, public and private ?
General Remarks
-M. D.
-189 N. C.
469-7-21-9.3-2500.
BULLETIN
OF THE
florth Carolina Board of Health
Published Monthly at the Office of Secretary of the Board, at Raleigh, N. C.
Geo. G. Thomas, M T>.,Pres., Wilmington.
8. Wkstray Battle, M. D.,..Asheville
W H. Hakrell, m. d Williamson,
John Whitehead. M. D., ...Salisbury.
C. J. O'Hagan, M. D
J. D Spice k.M.D
J L Nicholson, M. I> ,
A. W. Shaffer, San Kng
.. .Greenville.
Goldsboro.
Ricliliinds.
Raleigh.
Richard H. Lewis. M. D , Secretary ttnd Treasurer, Raleigh.
Vol. XIII. JULY, 1898. No. 4.
SMALLPOX IN NORTH CAROLINA.
During the past month there has been
a material spread of the disease both as to
the number of cases and localities infected.
When we last went to press, it was report-ed
as present at only two points—States-ville
and Vanderborg's Chapel, both in
Iredell county. At this present writing
(Jul}7 19), smallpox exists in addition at
Mooresville, 1 case; Elmwood, 2—both in
Iredell ; Asheville, 1, which is nearly well;
Catawba, 6, in one family in southeastern
part of county ; Cleveland, in Rowan
county, 7; Reidsville, 1; Durham, 1.
When the Superintendent of Health of
Rowan county was first notified of the
existence of smallpox at Cleveland he
found 20 cases, 13 of whom had recovered.
They had been diagnosticated as chicken-pox,
urticaria, and pemphigus and no pre-cautions
whatever were taken in conse-quence.
The people, we are told, called
it " elephant itch "—not a bad name, as
the eruption of smallpox is about the big-gest
thing of its class, in what it means, at
any rate.
A negro from Cleveland went to Reids-ville
and was there two days with tbe
eruption of smallpox on him before he
was discovered. During that time he went
on an excursion and mingled promiscu-ously
with his people. One of these who
had been exposed went from Reidsville to
Durham in the beginning of the eruption
stage. Although sought for, he was not
found until next morning, after he had
slept in the same room with several others.
Reports from Asheville, Iredell county,
generally, Cleveland and Durham, show
everything in good shape except the re-luctance
in too many instances of the peo-ple
to be vacoinated. The reports, how-ever,
from Catawba county and Reidsville
are not at all satisfactory, and we fear a
spread of the disease in those localities.
IN REGARD TO SMALLPOX.
While the instructions for quarantine
and disinfection issued by the board sev-eral
years ago in compliance with the
!' quirements of Section 9 of the Act in
Relation to the Board of Health, really
embody all that is necessary, if faithfully
carried out, for the restriction of contagi-ous
diseases, it is thought advisable in
view of the prevalence of smallpox in one
30 BULLETIN OF THE NORTH CAROLINA BOARD OF HEALT H.
section of the State, and the strong proba-bility
of its spreading, to issue fuller and
more specific directions as to the manage-ment
of that particular disease.
In order to be perfectly plain it may be
necessary to be somewhat elementary and
the well informed health officer must not
consider what is said as a reflection upon
his intelligence and knowledge. It should
be remembered that this is merely a sup-plement
to the "Instructions" and the
two must be read together.
We will consider the subject in its rela-tion,
i, to the patient; 2, to the physician;
3, to the general public; 4, to the muni-cipality,
and finally, 5, to vaccination.
I. The Patient.—Owing to the tenden-cy
in human nature to put away disagree-able
things it seems that in many cases
the attending physician is loath to admit
that the case is one of smallpox and calls
it chickenpox, urticaria and even pem-phigus,
while the people, in one locality
at least, denominate it "elephant itch."
When a mistake is made in the diagnosis,
or until it is correctly made, no precau-tions
are taken, as a rule, and free inter-course
with the patient being allowed, the
infection is spread. The diagnosis is not
difficult, but as no chances should be
taken, the obviously proper thing to do
whenever there is any doubt about it is to
manage the case as if it were smallpox.
When smallpox is prevailing every one
with an eruption who a few days before
its appearance had headache, pain in the
back and fever, should be strictly quaran-tined
until time has settled the question.
Above all things the patient should be
properly cared for. This is not a super-fluous
suggestion—as it ought to be—for
it occasionally happens that the cry of
smallpox produces such an acute and gen-eral
panic that the poor sufferer is more
or less neglected, for a while at least.
There is no excuse for this, as thoroughly
vaccinated persons can handle such cases
with as little danger as they could measles.
2. The Physician.-—The greatest care
should be taken by the physician to avoid
carrying the infection to others. He
should have a special suit of clothes dur-ing
the warm weather of some material
that will wash—or better, perhaps, a long
gown of linen or cotton, buttoning close
around the neck above the collar and
tightly around the wrists, to be worn over
his ordinary clothes, with a cap of paper
or oiled silk completely covering his hair,
while his feet are protected by rubber
shoes. The garments should be donned
in an uninfected room, or out of doors if
there is no room, and removed upon re-turning
to the same from the room of the
patient. If the disease is present in only
one house, the special suit can be left
there but not in the room with the patient.
If, however, there be cases in other houses
to be seen, it can be rolled up and carried
in a close-shutting hand-bag. To make
assurance doubly sure it would be well
after the rounds for the day have been
made to hang it up in a box or closet or
wardrobe in an unoccupied room and dis-infect
it with one of Schering & Glatz's
small formaldehyde lamps. Before going
to bed hang it out of the window to remove
the formaldehyde odor. Do not forget to
disinfect the hand-bag also, if one is used.
Before leaving the premises the hands and
face, (beard particularly) should be wash-ed
with some reliable antiseptic—bichlo-ride
of mercury, 1 to 2000, or a 2 per cent,
solution of carbolic acid, for example.
3. The General Public.—The people
should bear in mind the fact that there is
no reason whatever for becoming panic-stricken
at the announcement of smallpox
in their community—by no means such
good reason as on the appearance of diph-theria
or scarlet fever. In smallpox alone
of all the contagious diseases have we a
sure preventive—vaccination. All one has
to do in such circumstances is simply to i;et
his physician to successfully vaccinate him
and go on his way rejoicing without the
BULLETIN OF THE NORTH CAROLINA BOARD OF HEALTH. 3 1
least fear or anxiety. Should the disease
become epidemic and the first vaccination
fail to take, it would be well for the sake
of certainty to be re-vaccinated at the end
of a week. It is to be borne in mind that
this advice regarding the necessity for
vaccination applies with almost equal
force to those persons who have been
vaccinated in childhood and have reached
adult life. For while it is true that the
primary vaccination done in early life
may in most instances protect the persons
through life, this immunity for so long a
period cannot be assured, and to make
themselves safe, it is most advisable to
have the vaccination done again. This
will appear reasonable, when it is remem-bered
that if the person vaccinated in
early life does contract smallpox, it will
only develop into a very mild form, vario-loid
; but it must not be forgotten that this
mild form, this varioloid is of the same
nature as the severer forms and will excite
in the uuvaccinated typical and often fatal
smallpox. Good citizens should and
would hold up the hands of the powers
that he and cheerfully render every possi-ble
assistance in carrying out thoroughly
and loyally the plans devised for stamp-ing
out the disease. No dependence, to
the exclusion of vaccination, should be
placed upon quarantines, for inland quar-antines
are notoriously ineffective.
4. The. Municipality.—The authorities
of any city or town liable to become in-fected
from other points should not wait
until the disease actually appears in their
own community but make their prepara-tions
for taking care of and checking its
spread in advance. The proper manage-ment
of smallpox demands a hospital con-sisting
of at least four rooms—preferably
two small houses of two rooms each—for
the separate accommodation of both sexes
of the two races; and a larger house for
the detention of those known to have been
exposed, until the period of incubation
—
say fifteen days—has passed. As we never
think lightning is going to strike us such
complete anticipatory preparation can
hardly be expected, but preliminary ar-rangements
ought to be made for provid-ing,
with the least possible delay, these
necessary buildings. Tents would answer
in warm weather. When a case appears
in the town itself an abundant supply of
first-class virus should be ordered by wire,
arrangements should be made with a suffi-cient
number of physicians to perform the
work quickly, and everybody not giving
satisfactory evidence of previous vaccina-tion
should be vaccinated. If not already
in existence, such ordinances as may be
necessary, with sufficient penalties attach-ed,
should be immediately enacted. Sec-tion
25, chapter 214, Laws of 1893, gives
all incorporated towns the fullest power
in this matter, whether given in their
charters or not.
5. Vaccination.—There is, we regret to
say, considerable opposition to vaccina-tion
among the people. This is due chiefly
to the prejudice of ignorance, and is,
therefore, more difficult to overcome.
There is not sufficient ground for this
prejudice. While it is true that "bad
arms" occasionally follow vaccination it
is but rarely, if the proper precautions are
taken in making the vaccination and
decent care is taken of the arm afterwards.
If good bovine virus is used there is no
danger of the transmission of any disease.
The heifers in the best establishments are
always tested for tuberculosis—even if
tuberculosis can be transmitted in that
way, which is extremely doubtful, to say
the least. Admitting that there is some
ground, though by no means sufficient,
for the breadwinner of a family to object
for himself, there is none for his children.
In this connection we believe it would be
not only humane but wise, from a purely
business point of view, for all large em-ployers
of labor, as mill-owners with us,
to insist on the vaccination of all opera-tives,
agreeing, in case of disability there-
32 BULLETIN OF THE NORTH CAROLINA BOARD OF HEALTH.
from, to pay half wages or at least enough
to prevent suffering.
Vaccination is one of the simplest of
operations, but many bad arms are un-doubtedly
traceable to its improper per-formance—
to the neglect of a little care.
Thorough asepsis should be observed.
The arm should be scrubbed clean with
soap and water, and the vaccination per-formed
with a sterilized instrument, the
point itself, which has already been ster-ilized,
if points are used, or if a steel in-strument
be employed, by wiping i clean
and passing it through the flame of an
alcohol lamp after each vaccination. To
avoid the necessity of carrying the alcohol
lamp around in house to house visitation,
it has been suggested that the vaccinator
carry a paper of fair-sized needh s with
hi 111, and with these needles scarify the
place where he intends to introduce the
virus, using a fresh needle for each
patient. Do not make the scarifications
over a quarter of an inch square, and
avoid, if possible, drawing blood, as the
clot in drying takes up and holds some of
the virus. It is recommended three or
four of these little scarifications be made
quite close together in a group. The best
opinion at present is that pus infection
is less liable to follow the use of the
glycerinated lymph, though the points
have many friends on account of their
convenience and the rapidity with which
they can be used. Vaccinate. Vaccinate!
VACCINATE ! ! VACCINATE ! ! !
REVIEW OF DISEASES FOR JUNE. 1898.
(SEVENTY-SIX COUNTIES REPORTING.)
Eighty-five counties have Superinten-dents
of Health.
Except in the case of the more conta-gious
and dangerous diseases, the Super-intendent
has, as a rule, to rely upon his
own information alone, since few physi-cians
can be induced to report cases of
non-contagious diseases to him.
Where the number of cases is not given,
or the prevalence of a disease otherwise
indicated, its mere presence in the county
is to be understood as reported.
For the month of June the follow-ing
diseases have been reported from the
counties named:
Measi.es.—Davidson, 6 ; Forsyth, in
all parts; Martin, 4; Mecklenburg, a few;
Pitt; Rockingham; Vance, 3; Warren;
Wayne, 2—8 counties.
Whooping-Cough. — Ashe, 10; Dur-ham;
Granville; Harnett, afew; Northamp-ton;
Onslow, 10; Pasquotank, 2; Rocking-ham;
Vance, 12; Warren; Washington,
25; Yadkin, man)-—12 counties.
Scarlatina.—Catawba, 2; Rocking-ham,
1.
Typhoid Fever.—Alexander, 1 1 ; Beau-fort,
3; Burke, 4; Cabarrus, 10; Caldwell,
in several sections; Catawba, 8; Cherokee,
4; Clay, 2; Cleveland, 12; Columbus, 3:
Davidson, 4; Durham, 2; Edgecombe,
several; Gaston, in nearly all parts;
Greene, 3; Guilford, several; Harnett, a
few; Henderson, 1; Hertford, 3; Iredell,
in all parts; Jackson, 16; Jones, 2; Lin-coln,
4; Macon, 18; Madison; Martin, 5;
Mecklenburg; Mitchell, 20, malignant in
type, chiefly in the western part; Nash, a
few; New Hanover, 8; Northampton;
Orange, 2; Pasquotank, 8; Pender, 1; Per-quimans,
in all parts, 12 cases; Pitt, gen-eral;
Polk, 1; Randolph, 5; Robeson;
Rockingham, 3; Rowan; Rutherford, a
few; Sampson, in many parts; Stokes, 3
Surry, 5; Union, 25; Vance, in many parts;
Wake; Washington, 1; Waiauga, in all
parts, 15; Wayne, 3; Wilkes; Yancey, a
few—53 counties.
Maeariae Fever. — Cabarrus, Ca-tawba,
in all parts; Chatham; Columbus;
Davidson, in all parts; Durham, in nearly
all parts; Greene; Halifax; Harnett, along
the Cape Fear; Iredell; Johnston; Jones;
Lincoln, a few cases; New Hanover,
BULLETIN OF THE NORTH CAROLINA BOARD OF HEALTH. 33
Northampton, in all parts; Onslow;
Orange, a few; Person; Robeson; Rowan;
Union; Warren, in all parts to a limited
extent; Wayne; Wilson, in all parts—24
counties.
Malarial Fever, Pernicious —Har-nett,
1.
Malarial Fever, Hemorrhagic—
Cabarrus, 2.
Uiarrhoeal Diseases (including dys-entery).—
Bertie; Cabarrus, throughout
the county, general; Chowan, general;
Cleveland; Gates; Greene; Haywood, gen-eral;
Henderson; Jackson; Lincoln; Mc-
Dowell; Macon, general ; Or slow, general;
Pasquotank ; Perquimans, general; Person;
Robeson; Rockingham, general; Ruther-ford;
Sampson, in many parts; Stokes,
general; Surry, general; Transylvania;
Union, general; Warren, in all parts to a
limited extent; Washington, general; Yad-kin;
Yancey, in many parts—27 counties.
Pneumonia. — Cleveland ; Jackson;
Onslow, 2.
Smallpox.—Buncombe, 1; Catawba, 6
in south* astern part; Iredell, 18—in hos-pital
at Statesville 14, at Mooresville 1,
at Vanderborg's Chapel 1, at Klmwood,
2; Rockingham, 1 in Reidsville; Rowan,
20 at Cleveland.
Glanders.—Mecklenburg, 3 cases in
children reported from lower part of
county, contracted from a horse. They
were not very severe, and are now well.
The horse was burned and the children
isolated. No new cases have occurred
among animals or human beings. Acute
coryza, enlarged glands of neck and fever
were the symptoms noted.
Cholera in Chickens.— Clay.
Cholera in Hogs.—Gates, Jackson,
Onslow.
Distember in Horses.—Jackson.
Hydrophobia —Catawba.
Summary of Mortuary Reports for June.
1898 (Twenty-four Towns).
Only those towns from which certified
reports are received are included:
White. Cord. To/a/.
Aggregate popula-tion
87,598 66,010 153,608
Aggregate deaths . . 109 130 239
Representing tem-porary
annual
death rate per
1,000 15.0 23.6 18.7
Causes of Dca/h
.
Typhoid fever 7 9 16
Malarial Fever ... 2 4 6
Whooping-cough . . 1 1 2
Pneumonia 3 2 5
Consumption 6 10 16
Brain diseases 6 4 10
Heart diseases 8 6 14
Neurotic diseases 033 Diarrhceal diseases. 27 34 61
All other diseases. . 46 51 97
Accident 3 6 9
109 130 239
Deaths under five
years 43 54 97
Still-born 1 7 8
34 BULLETIN OF THE NORTH CAROLINA BOARD OF HEALTH.
Mortuary Report for June, 1898.
Towns
and rkpokteks.
ASHEVILLE
Dr. M. H Fletcher.
CHARLOTTK
Dr. b\ O. Hawley
DURHAM
Dr. J. Ai. Manning.
fiOLDSBORO
D.J. Broadhurst,C.Ck.
OREENSBORO
J.S.Michaux, OityClk.
HENDERSON
Dr. Goode Cheatham
HILLSBORO
Dr. 0. D. Jones.
LENOIR
Dr. A. A. Kent.
MARION
Dr. B. A. Cheek.
MONROE
Dr. J.M.Blair
NEWBERN
Hugh J. L.ovick,C.Ck
OXFORD
Dr. G. A. Goggesball.
RALEIGH
V. F. Kale.Clerk K.H.
ROCKINGHAM
Dr. W. M. Fowlkes.
ROCKY MOUNT
Dr. G. L Wimberley.
SALEM
.s. ( :. Butner, Mayor.
SALISBURY
Dr. W. L. rump
SCOTLAND NECK
J A. Perry, Mayor.
TARBORO
Dr. L L. Staton.
WARRENTON
Dr. P. J. Macon
WASHINGTON
Dr. D. T. Tayloe.
WELDON
.J. T. Gooch, Mayor.
WILMINGTON
Dr. \V. D. McMillan.
WILSON
Dr. A. Anderson.
Popula-tion.
«
K.(MH)
5.0(H)
17.154
9,000
4.IMH)
2,0011
3,501
2,500
5.50U
2.51 M)
2,260
2,000
400
3<hi
900
880
75o
250
1,800
«K)
3,500
6,000
1,200
1,100
K.500
7,800
1,300
450
1,600
1,000
4. KM)
450
4,00)
2,000
775
425
1,200
1,300
070
785
3,000
2.500
700
750
10,1 (HI
15,000
2.500
2,300
I3,(HHJ
26,153
6.000
7,000
8,000
4,2.0
7(H)
1,20)
1,000
2,4(H)
9,30)
2.3(H)
it;.)KHi
1,750
2,600
4,550
0,000
1,200
2,50)
1,755
5,500
1,450
25,00)
4,800
Tempo-rary
Annual.
Death-rat
k
per LOW.
X
15
28 8
11 2
24.0
21.0
0.0
10 3
1(1.!)
43.2
10 7
24.0
0.0
01)
13.3
0.0
10.0
00
18.3
20.0
20C.
32.0
50.0
32.7
22.0
22.4
0.0
7.5
36.0
8«
0.0
18.0
30.0
15 5
20.0
18.5
37.1
30.0
280
43.2
0.0
10.0
14 4
20.0
1..2
0.0
20.3
15.0
1)
8
21.0
10.9
0.0
10.0
12.0
15.0
27.8
41.7
22.5
0.0
18.5
7.'.)
22.0
100
19.2
33.8
34 9
8.3
17.8
10.0
®
<3j
J
1
1
1
1
2
1
...
1
2
2
1
1
2
BULLETIN OF THE NORTH CAROLINA BOARD OF HEALTH. 35
County Superintendents of Health.
Alamance
36 BULLETIN OF THE NORTH CAROLINA BOARD OF HEALTH.
[You are asked to fill out and mail one of these forms to the Superintendent of Health
of your County on or before the third of each month, that he may use it in making his
report to the Secretary of the State Board]
Have any of the following diseases occurred in your practice during the month
just closed. If so, state number of cases.
Whooping-cough Typhoid Fever —
Measles Typhus Fever
Diphtheria — Yellow Fever
Scarlet Fever Cholera
Pernicious Malarial Fever Small-pox
Hemorrhagic Malarial Fever Cerebro-spinal Meningitis -
What have been the prevailing diseases in your practice?
Has any epidemic occurred among domestic animals ? If so, wbat ?
What is the sanitary condition of your section, public and private?
General Remarks
-M. D.
-iS^ N. C.
523--S-29-98-2300. BULLETIN
OF THE
florth Carolina Board of Health.
Published Monthly at the Office of Secretary of the Board, at Raleigh, N. C.
Geo. G. Thomas. M D., Pres., Wilmington.
S. Westray Battle. M. D.,..Asheville W H. Harrell, vt. D„ Williamston.
John Whitehead. M. D Salisbury.
C. J. O'Hasan, M. D., Greenville.
J. D Spicek. M. D Goldsboro.
J L. Nicholson, M. I) Rlchlands.
A.W.Shaffer, San Eng., Raleigh.
RICHARD H. LEWIS. M. D , Secretary and Treasurer, Raleigh.
Vol. XIII. AUGUST, 1898. No.
NATIONAL CONFERENCE OF STATE AND
PROVINCIAL BOARDS OF HE4LTH.
This, in our opinion, practically the
most valuable of the sanitary organiza-tions
of the country, met in annual ses-sion
at Detroit on the 9-11 August. The
time of the meeting was set to accord with
that of the Michigan State Board of
Health so as to assist in the celebration of
the Quarter Centennial of the latter.
The first day of the three was given es-pecially
to the Michigan exercises. A
number of valuable papers were read and
words of congratulation for the admirable
work done in the past twenty- five years
by this progressive board, one of the best
in the country, were spoken, and the oc-casion
was a success, although the at-tendance
of local health officers was dis-appointing.
The last two days were devoted to the
work of the Conference, saving a large
slice of the second day consumed by the
graceful hospitalities <>f Messrs. Parke,
Davis & Co., and of the local committee.
We were greatly impressed by the mag-nitude,
completeness and finish of the
work done by this great drug house.
Particularly were we pleased with all the
arrangements for the preparation of the
diphtheria and other anti-toxins. No
pains or expense seemed to be spared to
produce the very best quality of every
thing. The morning session of this day
was given up to the papers by represen-tatives
of the various boards of health set-ting
forth the best methods of sanitary
work according to their experience, with
suggestions as to possible improvements.
The evening session was devoted to the
discussion of the purification of drinking-water.
The last day was consumed
chiefly by a thorough consideration of
tuberculosis, etiologically, pathologi-cally,
therapeutically and sanitarily. The
paper of the day was by Dr. D. E. Sal-mon,
of the United States Bureau of Ani-mal
Industry on the variations of the
tubercle bacillus in birds, animals and
fishes. The general opinion seemed to be
in favor of the establishment of sanatoria
for tuberculous cases, supported in part at
least, by the State. We fear that such an
idea is visionary, and that the same
amount of money might be made much
more- effective in other ways in prevent-ing
the spread of tuberculosis. .
38 BULLETIN OF THE NORTH CAROLINA BOARD OF HEALTH.
Detroit is a very attractive city and is a
favorite meeting place for all sorts of or-ganizations.
We can now understand
whv it should be.
PURE MILK.
We are pleased to learn from the news-papers
that the Charlotte Medical Society,
in consequence of a paper read before it
by Dr. I. W. Faison on "Some of the
Dangers of Milk," has appointed "a com-mit
tae to investigate the entire milk
question and report at the next meeting."
Good for the Charlotte Medical Society!
We hope their action may result in some-thing
of practical value. Nearly two
years ago at a health conference in the
same city we read a paper on the " Infec-tiousness
of Milk, '
' in which we expressed
the hope that that progressive town would
take the initiative in establishing muni-cipal
regulation of the milk supply, but
nothing came of it. We hope to return
to this subject when we have more space.
DISINFECTANTS AND DISINFECTION.
Some body has said that the best exe-cutive
officer is the one who can get the
most work out of other people. Acting
on that principle we propose, after mak-ing
our acknowledgements, to reprint from
The Sanitary Inspector, the official bul-letin
of the Maine Board of Health, the
very complete circular on the above sub-ject,
the result of "the laborious work of
months" by the excellent secretary, Dr.
Young. We have already printed and
circulated in "Instructions for Quarantine
and Disinfectants '
' information as to all
the older disinfections,

library of
(Dje Unbersthj of riortt) Carolina
COLLECTION OF
NORTH CAROLINIANA
EKDO W ED BY
JOHN SPRUNT HILL
of the class of 1889
.
This book must not
be taken from the
Library building.
\^
-tf>
\#
v'& w!$tf^
orm No. 471
355-4-19-98-2800.
BULLETIN
OF THE
florth GaFolina Board of Health.
Published Monthly at the Office of Secretary of the Board, at Raleigh, N. C.
Geo. G. Thomas, M. D., Pres., Wilmington.
S. Westray Battle, M. D.,..Asheville
W. H. Hakrell, M. D., Willlamston.
John Whitehead, M. D., Salisbury.
C. J. O'Hagan, M. D., Greenville.
J. D Spicer, M. D., Goldsboro.
J L. Nicholson, M. D., Richland s.
A.W.Shaffer, San Eng., Raleigh.
Richard H. Lewis, M. D , Secretary and Treasurer, Raleigh.
Vol. XI1£ APRIL, 1898.
—r
No. yz.
ELECTION OF COUNTY SUPERINTENDENTS
OF HEALTH.
Under the law as amended by the last
Legislature, County Superintendents of
Health are to be elected annually on the
first Monday in May. We sincerely hope
that the several boards of County Commis-sioners
will elect the best man available to
this responsible office, and we especially
hope that those few boards which failed to
elect a year ago will not overlook it again.
The law is mandatory on the subject and
allows the board no discretion in the mat-ter,
and a failure to elect is a plain viola-tion
of the oath of office.
SMALLPOX IN NORTH CAROLINA.
On the 30th of March we received a
telegram from the Superintendent of
Health of Rowan county announcing "a
probable case of smallpox " at Salisbury.
A subsequent report stated . that it was
genuine and that the patient would re-cover.
The person affected was a colored
postal clerk on the run between Salisbury
and Knoxville. The source of contagion
was easily traced to a case of smallpox
which occurred and remained in the
clerk's Knoxville boarding-house. Dr.
Whitehead, the superintendent, promptly
took the necessary preventive measures
how thoroughly and successfully is at-tested
by the fact that up to this present
writing (three weeks) no new case has
occurred.
On the 14th inst. (April 1, Dr. Fletcher,
the municipal health officer of Asheville,
reported a case of smallpox in a negro
ten days from Jacksonville, Fla. As the
case occurred in a negro restaurant we
are anxious lest the disease spread, not-withstanding
the precautions taken by
the health officer.
We regret to learn that a deep prejudice
again.st vaccination crops up every now
and then, chiefly among the ignorant
—
the very element of the population which,
owing to the over-crowding and other un-sanitary
conditions usually co-existent
with ignorance, is in peculiar need oi tin-protection
afforded by vaccination. The
question is how to overcome this preju-dice.
We have more than once asked our
readers for suggestions as to the best
practical method of getting the people
vaccinated, but not one has responded. It
28o BULLETIN OF THE NORTH CAROLINA BOARD OF HEALTH.
is easy to understand why it is a problem
extremely difficult of a practical solution.
Fortunately the feeling against vaccina-tion
is sporadic, and we shall console our-self
with the hope that as time passes and
knowledge spreads this prejudice will
disappear.
Since the a. was sent to the printer
we have received the following, under
date of April 19th, from Dr. Fletcher:
" We have the second case of smallpox,
imported from Spartanburg, S. C. She
ran away from Spartanburg to prevent
being taken to the pest-house. Was
broken out when she came to Asheville.
Was in her own house from Monday
night till Friday morning before she was
discovered, and a number of people went
to see her. Both patients (negroes) are
properlv quarantined in a pest-house
which we established with difficult}-—met
with armed resistance. Judge Hoke re-fused
to enjoin our Board of Health till
we had a hearing. Long before the day
set for a hearing came I had my house
built (a comfortable two-room house)
and my patients in it. For fear of having
to pay a big bill of costs the opposition
withdrew the application for injunction.
We are vaccinating every one as fast as
possible ; are meeting with some opposi-tion.
We have a compulsory vaccination
ordinance and mean to fight it out along
these lines with tact and discretion."
It is evident that the Health Officer of
Asheville is made of the right kind of
timber.
THE HOME OF CONSUMPTION.
We print below an extremely interest-ing
communication bearing upon the pro-duction
of consumption. It indicates in
the first place that consumption is essen-tially
an indoor disease. There is great
probability that the germ which causes
consumption is quickly destroyed when
freely exposed to light and air. Indeed,
this is not a matter of conjecture, but has
been demonstrated time and again. And
while the practice of expectorating, or
spitting, on the streets is to be deprecated
—whether by consumptives or other per-sons—
the great danger comes from such
material being cast into dark, unventi-lated
rooms, where the germs may live
for an unknown time—probably for years.
It will be noted that the house referred to
below, in which fifteen persons probably,
and thirteen certainly, died from con-sumption
or tuberculosis, "is very damp
and the cellar in bad condition." and fur-thermore
it is surrounded by dense foli-age.
It has long been known that dampness
is a factor in the production of consump-tion,
probably acting as a predisposmg
cause. It has been shown for a number
of towns that subsurface drainage and
consequent drying of the soil has always
lowered the death rate from consumption
where a wet soil had been the condition
theretofore. The dense foliage spoken of
would cut off both air and light. Such a
house, becoming infected, would remain a
center of infection for a long time.
The most satisfactory part of Dr. Gas-ton's
statement is his reference to public
opinion regarding this house. It is safe
to say that no ether family will move into
it. The question may be referred to the
court to determine the power of the Board
of Health to order its destruction.
What is most needed is that public
opinion throughout the land shall be
brought to the level of that of the people
of Mineral Ridge. Not that it is neces-sary
that houses in which people with con-sumption
have lived or died need be de-stroyed,
for such houses can be made per-fectly
safe by modern methods of disin-fection.
And there seems no escape from
the conclusion that cases of consumption
should be reported to the health authori-
BULLETIN OF THE NORTH CAROLINA BOARD OF HEALTH. 28
1
ties, in order that this may be done. Fol-lowing
is the communication from Dr.
Gaston:
MiXERAi, RiDGE, O., March 29, 189S.
Dr. C. O. Probst. Sect etary State
Board of Health, Columbus, Ohio:
Dear Sir—Relative to the house in this
village, mentioned some time since, which
has sheltered so many tubercular victims,
I enclose you a history of the same as
nearly correct as I could obtain it from va-rious
sources. I am informed that it was
thoroughly disinfected about one year ago;
that the building is very damp and cellar
in bad condition; that in no way will other
residents of the town be satisfied until it
is fired. The mother refuses to give up
the house, although urged to do so by the
remaining children. The local Board has
discussed this matter, and now asks the
State Beard to take such action as they
deem best in the matter. The residents of
this place look upon the home with hor-ror,
and if the family were to move out, I
have no doubt that the building would go
up in flames inside of t\\ enty-four hours,
and not a hand would be turned to save it.
THE HISTORY OF A HOME.
This house was constructed about 1830,
and was occupied by a family of the name
of F. It is related that a young man who
lived with the family was " always ailing
and in delicate health," but the only
death was that of a baby with bowel trou-ble.
They resided in the premises until
about 1846, when the house was occupied
by a family named S. They were an un-usually
strong and healthy family when
they first came to this place, with no pre-vious
tubercular history. The first one
connected with this family to pass away
was a lady boarder, but information does
not reveal the cause of her death. It was
quickly followed, however, by the death
of two sons, two daughters, father and
mother, from tuberculosis, leaving only
one son, who had previously gone to Illi-nois
on account of his health, and who
still survives. From 1879 until now the
house has been held by the present occu-pants.
There is no history whatever of
consumption in the family prior to their
coming to this house. The daughter who
died recently was born here. Her death
was the seventh in the family in as many
years from pulmonary tuberculosis. A
sister, two brothers and a mother survive,
but the characteristic traces of the disease
are plainly visible in the faces of one
brother and the surviving sister. The
building is a story and a half high, and is
surrounded by dense foliage.
Yours truly,
Jas. E. Gaston, M. D. —Ohio Sanitary Bulletin,
We take much pleasure in printing the
above most impressive statement of facts,
for it is on the lines indicated by our
friend, Dr. Probst, viz., abundance of
fresh air and sunlight, and the thorough
disinfection of infected houses, that the
ravages of " the great white plague " can
be most effectively curtailed. As "The
Best Method of Preventing Tuberculosis '
'
has been selected by the Leader of De-bate,
Dr. Burroughs, of Asheville, for dis-cussion
at the approaching meeting of the
State Medical Society, we will reserve
what we have further to say on this—lit-erallv
from the sanitarian's point of view
—
most important subject for our next issue.
We desire, however, to call particular at-tention
to the next article as showing how
easily, simply and cheaply the disinfec-tion
can be accomplished.
FORMALDEHYDE DISINFECTION AGAIN.
During the month tests have been made
of still another, and the latest, apparatus
devised for formaldehyde disinfection.
This consists, substantially, of a copper
receiver of about half a gallon capacity,
from the bottom of which a small pipe
leads to a coil heated by a kerosene lamp.
The agent is the usual 40 per cent, for-maldehyde
solution (formalin), which is
slowly admitted to the coil, where it is
volatilized by the kerosene flame and the
resulting gases are blown through a rub-ber
tube into the room through the key-hole
of a door. It is another modification
of the Trillat autoclave, but possesses
some advantages. It is easily handled,
282 BULLETIN OF THE NORTH CAROLINA BOARD OF HEALTH.
free from danger of explosion and is op-erated
entirely outside the room to be dis-infected.
Its chief drawback is that which has
caused the abandonment of other "gen-erators"
of this type, to-wit, that when
the solution passes into the red-hot coil
the water is quickly boiled off, the solu-tion
becomes concentrated and parafor-maldehyde
is produced—consequently, a
considerable quantity of the available
formic aldehyd is blown into the room in
the polymerized state. A piece of paper
placed at the foot of the door through
which the gases were being blown gather-ed
a considerable quantity of paraform
which had dripped from the end of the
tube in the keyhole.
In the experiments, which were con-ducted
under the supervision of the agent
for the apparatus, six ounces ( 187.5 cc )
of the formalin were used 'for every 1 "OH
cubic feet of space, and the rooms were
kept closed five hours. Agar streak cul-tures
of the diphtheria bacillus and of the
B. frodigiosus were exposed in the rooms
in tubes, open and plugged, covered and
uncovered, and at different heights. In
closing his report, which is accompanied
by a detailed table, Dr. Gehrniaim says :
" We may, in general, say that the freely
exposed specimens were killed. The ger-micidal
effect was, however more marked
in specimens nearest the floor. Those
which were covered with one or more
folds of a sheet, or placed under pillows,
or in plugged tubes, were not always
killed.
'.' We were not able, in the five hours'
exposure, to obtain any greater efficiency
than with other methods of vaporizing
formaldehyde solution under pressure, or
of producing formaldehyde gas by the oxi-dation
of methyl alcohol."
Full}' as good, if not better, results
have been obtained in a number of disin-fections
during the month, made person-ally
by Dr. C. W. Behm, Medical Officer
in charge of the Disinfecting Corps. In
these disinfections formalin was also
used, but without the use of any appara-tus.
Ordinary bed sheets were employed
to secure an adequate evaporating surface,
and these, suspended in the room, were
simply sprayt-d with the 40 per cent, so-lution
through a common watering-pot
rose-head. A sheet of the usual size and
quality will carry from 150 to ISO cc. of
the solution without dripping, and this
quantity has been found sufficient for the
efficient disinfection of 1 ,000 cubic feet of
space. Of course, the sheets mav be
multiplied to any necessary number.
Cultures, both moist and dry, were ex-posed
for five hours in these experiments,
some in sealed envelopes and others
wrapped in three thicknesses of sheets or
folded inside of woolen blankets. Of the
former none showed growth after 73
hours' incubation, while the growth was
but slight in those wrapped in the blank-ets.
Surface disinfection was thorough,
while a much greater degree of penetra-tion
was shown in these expe'iments than
that secured by any other method.
The evolution of the gas from the
sprinkled sheets is exceedingly rapid
—
so much so that it behooves the operator
to vacate the room within a very few sec-onds
; while, after starting the ordinary
generator, he may remain ten minutes or
more without serious inconvenience.
When the room is opened after five hours
the density of the gas is still so great as to
preclude respiration until after doors and
windows have been opened some little
time. On the other hand, the air is
respirable within a very few minute* after
the sheet has been removed, and there is
no lingering smell of formal lehyde for
days after, as is the case where the gas is
evolved by the action of heat. This is
due to the fact that a minimum of para-form
is produced in the evaporation of
BULLETIN OF THE NORTH CAROLINA BOARD OF HEALTH. 283
the solution in this manner at the ordi-nary
temperature, and this is retained in
the meshes of the fabric, instead of being
precipitated on surfaces, to be slowly con-verted
into the gaseous form through
several days
.
If further experiments, which are now
being prosecuted by the Department,
shall confirm the results thus far obtained,
the problem of practical domestic disin-fection
by formaldehyde would seem to be
in a fair way to be solved.
—
March Report
Department aj Health City of Chicago.
WATER.
BY H. C. WOOD, M. D., PHILADELPHIA.
Many European physicians believe that
the most active cause of gastro-intestinal
disturbance in America is the habitual use
of ice water, and there can be no doubt
that flooding the stomach with large quan-tities
of ice water during eating has a ten-dency,
by lowering temporarily the tem-perature
of the viscus, as well as by dilut-ing
the gastric juice, to cause disturbances
of digestion, which, on repetition, may re-sult
in the production of gastric catarrh.
On the other hand, the habitual taking of
large amounts of water is very advanta-geous
for all gouty individuals, and in-deed
for all persons who eat more than
the needs of the system require, in which
latter class is included practically the
whole of the American people.
It would seem a prio i, probable, that
in its relations with water the human sys-tem
obeys to a greater or less extent the
ordinary physical ami chemical laws.
What is taken into the body must get out
of the body, sooner or later; and the dis-charge
of large quantities of water neces-sarily
increases the flow of secretion. The
old researches of Roux and of Boecker in-dicated
that the increase of the amount of
urine which follows the water drinking is
sometimes, but not always, accompanied
by an increase in the output of solids from
the kidneys. The cause of the differences
of effects has been shown by Meyer to de-pend
upon the condition of the body; the
excess of water in the system appears to
have very little influence upon tissue dis-integration,
but to be powerful in dissolv.
ing and carrying off—in other words, in
washing out—all excrementitious mate-rials,
whether such materials be due to
disintegration of the tissues themselves or
be educts from an excessive food supply.
The American habit of drinking water
has not, however, arisen lromthe prompt-ings
of an}- blind instinct leading the race
to attempt to wash out of the body the
products of excessive self-indulgence, or
the last taint of a gouty ancestry, but has
simply sprung from the climatic condi-tion.
The dry air (as compared with Eu-rope)
and the high temperature of the
summer months make the American throw
off water and make the system demand
water. The vacuum in the body must be
supplied. That the American people do
not drink more water than they need is
shown by the fact that the American man
is a drier individual, not only in his
speech but also in his tissues, than is the
European. True humor consists of a ker-nel
of truth surrounded by a hull gro-tesquely
unfit for it; and so the humorist
habitually expresses a physiological fact
when he makes John Bull in the cartoon
plump and succulent, and Brother Jona.
than hard and dry. Many years ago the
writer at a meeting of the physiological
sections of an International Congress,
said that a certain physiological operation
or procedure reported by European phy-siologists
did not produce the results upon
dogs which were alleged, unless indeed
the European canines were very different
from his American brothers, a suggestion
which led to a general titter until Brow-n-
Sequard got upon his feet and said that he
had studied and practiced vivisection on
284 BULLETIN OF THE NORTH CAROLINA BOARD OF HEALTH.
the two continent?, and that it was a fact
that the American people and the Ameri-can
dogs and lower animals were distinctly
different in vascularity from their respec-tive
kindreds in Europe; that operations in
vivisection which in Europe he could
scarcelv perform on account of the amount
of bleeding produced, he had done on the
American dog with almost dry tissues.
The American drinks water because he
is thirsty; he is thirsty because he sweats;
and he wants his water cold because he is
hot; the cooling of the system being de-manded,
but the cool temperature being
especiallv grateful to a heated throat.
What is the poor American to do ? He is
threatened with mummification if he does
not drink water; he is appalled by the
horrors of gastric catarrh if he does drink
water. The answer is obvious; drink wa-ter
between meals rather than at meals.
The drier the meals the less dilute the gas-tric
juice, the better theo-etically at least
is the digestion. Fortunately the ordi-nary
human being is made with a reserve
force, and so if he be in the ordinary con-dition
he need not study the number of
drops of water he takes with his meal; but
if he have any disease of the stomach or
feebleness of digestion it is well worth
while to count the drops.
Cold water has so good a taste when a
man is very heated that most people will
continue to take cold water, and a general
chilling of the body would seem some-times
to be of service. Nevertheless,
there probably are cases in which the sud-den
pouring of large masses of cold water
upon a stomach in a person who has little
reserve power has produced an immediate
violent disturbance. These cases are,
however, in our opinion, few; indeed, our
belief in their existence may be due to the
nursery teachings of our early childhood,
since if the truth must be spoken, in a
medical experience extending over thirty-five
years, we have never seen colic, col-lapse,
or any other acute symptom or con-dition
produced b}^ a cold drink. But for
fear that the nurserv bogie is the shadow
of a truth we would advise our readers
when hot to drink cold water si owlv. We
remember once, when two thirds dead of
thirst in the Texan desert, with what joy
we raised to our lips a quart mug of water
and drank it to the bottom without a
breath, but in an ordinary emergency a
half tumblerful of water, followed in a
moment or two (if it must be) by the
other half tumblerful of water, should sat-isfy
the ordinary individual.
—
American
Medico- Surg. Bulletin.
PHYSICAL EFFECTS OF ATTENDING
SCHOOL.
In what wav the bodily development of
children is affected by their attendance at
school has been closely investigated for
vears by Dr. Schmidt-Mounard, of Leip-sic,
who recently gave his results in an
address to the Lehrer-Verein of that city.
His results are as follows:
1
.
It is a difficult task to trace with ac-curacv
what effect attending school has
on the growth of children and on their
increase of weight ; but it is a fact demon-strated
beyond reasonable doubt that
children in the first vear of school attend-ance
gain less in weight and heieht than
thev do in preceding years, namely, only
one kilogram ftwo and one-fifth pounds')
in weight compared with four in early
vears, and five centimeters (two inches)
in height compared with seven before ;
and that the average proportions in this
respect are not again attained until in
later years ; and, further, that children
who do no' enter school until their
seventh year are stronger and better de-veloped
physically than those who enter
a year earlier.
2. Acute sicknesses are not caused by
the fact that children must study, but are
BULLETIN OF THE NORTH CAROLINA BOARD OF HEALTH. 285
produced by defective hygienic school-rooms.
Lack of cleanliness, of fresh air
and light, decrease the ability of children
to resist the attacks of contagious dis-eases.
This, too, becomes better in later
years.
' 3. Chronic troubles, such as weakness,
headaches, insomnia, and nervous dis-orders
in general, are found to a much
greater degree in schools of higher grade
than iu the elementary. They increase
steadily in the case of girls to the age of
pubertv, frequently troubling as many as
fifty percent., while in the case of boys
the highest percentage is thirty-five per
cent. After that age, in consequence of
the increase of weight, they decrease to
twenty-seven per cent, in the case of
girls. Eight per cent, of children about
this age suffer from insomnia cnused
chiefly by social excitement at home. In
the higher grade of schools for boys, es-pecially
when there are no afternoon re-citations
and the pupils are compelled to
take exercise, the percentage of sickness
varies from twenty to thirtv-nine ; while
in the case of those schools where there
are afternoon recitations and no enforced
exercise, the percentage runs up as high
as seventy-nine. Eighteen per cent, of
boys in such schools complained of in-somnia.
4. The cause of these troubles is to be
found largely in the extra work assigned
to children at home, such as drawing,
lessons, music lessons, and the like, as
also to the fact that in schools physical
exercise is not nude compulsory, as it
should be.
The speaker closed his address with
these words : " The children are not too
weak for our schools, and for that reason
should not cease to attend ; but, rather,
our schools make too heavy demands on
the children, and for that reason these
demands should be made lighter."
—
The
Literary Digest.
BRAIN FATIGUE IN SCHOOL WORK.
A question of interest to teachers is
raised by a recent paper by Dr. Kemsies,
the headmaster of a large German school,
who gives his personal experience of the
conditions which influence the working
capacity of his pupils. We quote from
an abstract of his article in The Hospital:
" The best work, he says, is done at the
beginning of the week, after the Sunday
holiday ; and by Tuesday afternoon it
has already begun to deteriorate. Again,
the mornings produce the best work, and
the midday rest, during which the mid-day
meal is taken, does not produce the
same recuperation as the night's rest. If
these results are to be taken as correct,
it would seem as if many of our educa-tional
customs might be reformed with
considerable advantage. We have long
thought that a reversion to the two half-holidays
would be a great advantage to
the children, however much the teachers
might dislike it, and these investigations
only tend to confirm our idea. Young
ladies, again, used to go to school in the
morning and the afternoon, with a two
hours' interval between the two sessions.
But now it is thought desirable, we sup-pose,
that they should be free to pay calls
with their mothers in the afternoons, and
everything is crowded into one long
grind of four hours in the morning.
Moreover, a modern blackboard lesson is
a very different thing from the work that
used to be done in school hours, much of
which would now lie called preparation ;
and, although as a means of teaching facts
its value is obvious, so also is its power of
producing fatigue. Curiously enough,
the German experience is thai, gymnas-tics,
which we are apt to class with play,
produce the greatest fatigue of all, ren-dering
the work done after it practically
useless. But, then, the gymnastics arc-probably
done in a class, each pupil hav-
286 BULLETIN OF THE NORTH CAROLINA BOARD OF HEALTH.
ing to do as he is told. This is practically
another lesson, and is not to be put into
the same category with half an hour in a
fives-court, or at football. It must not be
forgotten that the effort to make teaching
interesting, which is its great character-istic
in modern times, does not really
lighten the burden on the child. It
makes learning easier, but it makes him
learn more ; it keeps him always at it,
and it steals from him those moments of
torpor and stupidity, of dreams and va-cancy,
in which his little brain used to
take furtive snatches of repose."
—
The
Literary Digest.
of wan-, of water in the city of Damascus.
4 and 5. I never cared of my neighbor's
business, and I cannot say how many
camel loads are brought to or sent from
Damascus.
('). Since Allah has sent his prophet, Mo-hammed,
into the world, who has cleansed
the w>>rld with fire and sword, things are
little better, but there is much to be done
vet, and much room for improvement.
And now my sweet lamb, do not ask
anv more questions, which are neither
good for you or anybody else. This is the
first and last blank I dlled out for you.
Saeam Aeeikum.
—Public Health Journal.
OTTOMAN STATISTICS.
The Bureau of Statistics of Paris in-duced
the French Government to ex-change
statistical matters with the Tur-kish
Government. Both governments
consented, and the French Bureau of Sta-tistics
has sent blanks to be filled out and
the}- have been handed by the French
Ambassador to the Turkish authorities.
The Parisian Bureau has sent six blanks.
The questions to be answered have been
the following:
1. What is the rate of deaths of the city ?
2. What is the rate of births ?
:;. What is the supply of drinking
water ?
4. How much goods are imported ?
5. How much goods are exported ?
6. General remarks pertaining to the
welfare and health of the people.
One blank came back filled out by the
Chief Magistrate of the city of Damascus.
The blank has been filled out thus:
Answer to 1. In Damascus everybody
must die on the command of Allah. Some
die young, some die old, but everyone
must die.
:!. I cannot answer answer this question.
Allah alone knows that.
3. Since time immemorial nobody died
REVIEW OF DISEASES FOR MARCH. 1898.
(seventy-eight counties reporting.)
Eighty-one counties have Superinten-dents
of Health.
Except in the case of the more conta-gious
and dangerous diseases, the Super-intendent
has, as a rule, to rely upon his
own information alone, since few physi-cians
can be induced to report cases of
non-contagious diseases to him.
Where the number of cases is not given,
or the prevalence of a disease otherwise
indicated, its mere presence in the county
is to be understood as reported.
For the month of February the follow-ing
diseases have been reported from the
counties named:
MEASLES.—Alexander, 2 ; Beaufort,
150; Caldwell, 20; Catawba, abundant;
Chatham, 20; Chowan, 25; Davie, many:
Franklin; Iredell, a few; Jackson, 2;
Johnston; Mecklenburg; Northampton,
numerous; Person, 1; Pitt, many; Rock-ingham,
in all parts; Rowan, 3; Stokes,
25, in all parts; Surry, a few, epidemic
abating; Transylvania; Wake, 6; Warren;
Watauga, 10; Wayne, 1; Wilkes, 43; Wil-son,
100; Yadkin, 12. 27 counties.
BULLETIN OF THE NORTH CAROLINA BOARD OF HEALTH. 287
Mumps.—Clay; Macon; Sampson;
Wayne.
Whooping-cough.—Chatham, 6; Da-vidson,
in all parts; Granville; Greeue,
10; Jackson, 6; Martin, 10; Montgomery,
30; Onslow, 5; Robeson, in all parts;
Rockingham, in all parts; Rowan, 2;
Wake. 1; Warren; Washington, 25, in all
parts; Wilkes, 35; Yadkin. 16 counties.
Scarlatina.—Buncombe, quarantin-ed,
recovered; Cumberland, 1; Halifax, 1;
Moore, 1 ; Northampton, 4.
Diphtheria.—Jackson, 2; Wake, 1;
Watauga, 5; Wilkes, 5.
Typhoid Fever.—Beaufort, 2; Craven;
Jackson, 4; Johnston, 2; Mitchell, 4; New
Hanover, 2; Pitt; Rowan, r; Sampson, 2;
Surry, 1; Swain, 2; Yancey, a few. 12
counties.
Malarial Fever —Chatham, 1;
Chowan; Columbus; Gaston, 1; New Han-over,
in all parts; Onslow; Person; Row-an,
Sampson; Wilkes. 10 counties.
Malarial Fever. Pernicious.—
Wilkes.
Malarial Fever, Hemorrhagic.—
Chowan, 1; New Hanover, 1; Onslow, 1.
Smallpox.—Clay, 1; Rowan, 1.
Diarrhceal Disease s.—Mitchell,
Onslow.
Influenza.—Alamance; Caldwell, in
all parts; Cleveland; Craven; Greene;
Henderson; New Hanover; Union; Yance;
Yancey. 10 counties.
Pleurisy.—Martin.
P n E u M N 1 a.—Alamance; Catawba;
Cleveland; Craven; Gaston; Iredell; Lin-coln;
Martin; Onslow; Pasquotank; Rock-ingham;
Transylvania; Union; Yance;
Washington; Watauga; Yadkin. 17 coun-ties.
Rheumatism.—Lincoln.
Rotheln.—Sampson
.
Distemper, in Horses.—Clay, Jack-son;
Moore.
No diseases of importance are reported
from, Ashe, Bertie, Bladen, Burke, Ca-barrus,
Carteret, Duplin, Durham, Edge-combe,
Forsyth, Guilford, Haywood,
McDowell, Madison, MeckleiVburg, Or-ange,
Pender, Polk, Randolph. Rich-mond
and Rutherford.
No reports have been received from
Anson, Hertford and Perquimans.
Summary of Mortuary Reports for March,
1898 (Twenty -two Towns).
Only those towns from which certified
reports are received are included:
White. CoI'd. Total.
Aggregate popula-tion
66,639 53.3 2 i 119,960
Aggregate deaths . . 61 73 134
Representing tem-porary
annual
death rate per
1. 000 11. o 16.4 13.4
Causes of Death.
Typhoid fever 3 1 4
Malarial Fever . . 1 o 1
Pneumonia 7 10 17
Consumption 10 19 29
Brain diseases 3 1 4
Heart diseases S 5 13
Neurotic diseases . 2 o 2
Diarrhceal disease 1 2 3
All other diseases. . 23 53 56
Accident - 3 2 s
61 73 134
Deaths under five
years 10 21 31
Still-born.. 3 q i 2
BULLETIN OF THE NORTH CAROLINA BOARD OF HEALTH.
Mortuary Report for March, 1898.
Towns
BULLETIN OF THE NORTH CAROLINA BOARD OF HEALTH. 289
County Superintendents of Health.
.Dr. J. K. Stockarcl.
Dr. T. F. Stevenson.
Alamance . .
Alexander. .
Alleghany
Anson Dr. E. S. Ashe.
Ashe Dr. L. C. Gentry.
Beaufort Dr. D. T. Tayloe.
Bertie Dr. H. V. Dunstan.
Bladen Dr. Newton Robinson.
Brunswick
Buncombe Dr. I. A. Harris.
Burke Dr. J. L. Laxton.
Cabarrus Dr. J. S. Laffertv.
Caldwell Dr. A. A. Kent.
Camden No Board of Health.
Carteret Dr. F. M. Clarke.
Caswell
Catawba Dr. F. L. Herman.
Chatham Dr. H. T. Chapin.
Cherokee Dr. S. C. Heighway.
Chowan Dr. R. H. Winborne.
Clay Dr. W. E. Sanderson.
Cleveland Dr. R. C. Ellis.
Columbus Dr. J. F. Harrell.
Craven Dr. L. Duffy.
Cumberland Dr. J.VanceMcGougan.
Currituck No Board of Health.
Dare
Davidson Dr. John Thames.
Davie Dr. James McGuire.
Duplin Dr. F. H. Arthur.
Durham Dr. John M. Manning.
Edgecombe Dr. L. L. Staton.
Forsyth Dr. John Bynum.
Franklin Dr. E. S. Foster.
Gaston Dr. J. H. Jenkins.
Gates No Board of Health.
Graham No Board of Health.
Granville Dr. A. G. Coggeshall.
Greene Dr. Joseph E.Grimsley.
Guilford Dr. A. E. Ledbetter.
Halifax Dr. I. E. Green.
Harnett No Board of Health.
Haywood Dr. J. Howell Way.
Henderson Dr. J. G. Waldrop.
Hertford Dr. John W. Tayloe.
Hyde No Board of Health.
Iredell Dr. Henry F. Long.
Jackson Dr. William Self.
Johnston
29O BULLETIN OF THE NORTH CAROLINA BOARD OF HEALTH.
[You are asked to fill out and mail one of these forms to the Superintendent of Health
of your County on or before the third of each month, that he may use it in making his
report to the Secretary of the State Board]
Have any of the following diseases occurred in your practice during the month
just closed. If so, state number of cases.
Whooping-cough
Measles
Diphtheria
Scarlet Fever _
Typhoid Fever
Typhus Fever—
Yellow Fever _
Cholera
Pernicious Malarial Fever Small-pox
Hemorrhagic Malarial Fever Cerebro-spinal Meningitis
What have been the prevailing diseases in your practice ?
Has any epidemic occurred among domestic animals ? If so, what ?
What is the sanitary condition of your section, public and private?
General Remarks
—M. D.
.189 -N. C.
S94-5-23-9S-2300.
BULLETIN
OF THE
Jlorth Carolina Board of Health.
Published Monthly at the Office of Secretary of the Board, at Raleigh, N. C.
Geo. G. Thomas, M D., Pres., Wilmington.
s. Westray Battle, M. D.,..As.heville
W H. Hakrell, M. D., Williamston.
John Whitehead. M. D., Salisbury.
C. J. O'Hagan, M. D., Greenville.
J. D Spice r, M. D., Goldsboro.
J L. Nicholson, M. D. Rich lands.
A. W. Shaffer, San Eng., Raleigh.
RICHARD H. Lewis, M. D., Secretary and Treasurer, Raleigh.
Vol. XIlX MAY, 1898.
ANNUAL MEETING OF THE BOARD.
As required by law, the annual meet-ing
of the Board was held at the same
time and place as the State Medical So-ciety,
viz., Charlotte, May 3-4. Drs.
O'Hagan, Battle, Nicholson, Colonel
Shaffer and the Secretary were present.
At the business meeting, on the 3rd, in
the unavoidable absence of President
Thomas, Dr. O'Hagan was elected Presi-dent/;*'
tern. In addition to the routine
business, the report of the Engineer of
the Board on the public water supplies of
the State was read and discussed at con-siderable
length. Upon the conclusion
of the discussion the Secretary was or-dered
to devote one issue of The Bul-letin
to its publication, together with
the chemical and bacteriological analyses
of the samples sent in by him. It will
appear next month.
An inspection of all the public institu-tions
of the State, by committees to be
appointed by .the President, was ordered.
On Wednesday, as has been the cus-tom
for many years, the Board met in
conjoint session with the State Medical
Society, Dr. Battle in the chair.
The Secretary read his annual report.
The subject receiving the most atten-tion
in the discussions was vaccination,
quite a number participating. In ihe
course of it, Dr. Francis Duffy, President
of the Society, described a device for
dressing vaccinated arms, which struck
us as being very practical and convenient
—so much so that we feel it to be our
duty to describe it for the benefit of our
medical readers, as we hope they have
much good vaccination work ahead of
them. The device may be briefly de-scribed
as follows : A piece of rubber
adhesive plaster three or four inches
wide and long enough to go about two-thirds
around the vaccinated arm, with
tapes attached to each end. The planter
is applied to the arm with its centre op-posite
the sore, the tapes hanging loose.
At each end of the plaster a roll of ab-sorbent
cotton is laid on the skin in the
line of the arm just at the attachment of
the tapes, so as to lift them above the
skin. The dressing is then applied, and
the tapes tied over it to hold it in place.
In each subsequent dressing the only
thing to do is to untie the tapes, renew
the dressing and re-tie them. Dr. Duffy
stated that he had found it much more
292 BULLETIN OF THE NORTH CAROLINA BOARD OF HEALTH.
satisfactory than the usual vaccination
shields, and we could well believe him.
In connection with the subject of Na-tional
Quarantine, the following resolu-tion
was unanimously adopted:
Resolved, That the North Carolina
Board of Health and the Medical Society
of the State of North Carolina, in con-joint
session assembled, endorse the Caf-ferv
bill enlarging the powers of the U.
S. Marine Hospital Service, and respect-fully
request our Senators and Represen-tatives
in Congress to support the same.
SMALL-POX IN NORTH CAROLINA.
Only one case has been reported in
May up to date of this writing, lsth.
This is a negro " missionary preacher '' at
Statesville. The notification, by tele-graph,
was received on the 17th, and no
particulars as to isolation, vaccination,
etc., have cmne to hand, but we feel as-sured
that Superintendent Long will care-fullv
look after these.
PRESIDENT DUFFY ON PUBLIC HYGIENE.
We take much pleasure in presenting
to our readers that portion of the admir-able
presidential address of Dr. Francis
Duffy, delivered at the recent meeting of
the State Medical Society at Charlotte,
relating to the public health. He says :
It may be like the re-threshing of old
straw to refer to the importance of pub-lic
hygiene, and the necessity of procur-ing
legislation for the promotion of that
object, but as that sort of straw has
yielded so comparatively little of the
grain which it is capable of producing, I
am impressed that we should continue to
thresh. As far as we are concerned, I do
not feel that it is necessary to remind
this body of these things, much less to
offer instructions, but with the people in
general, as well as their legal representa-tives,
it is different. They have not yet
found out the best way to spend their
money with the medical profession to get
the best returns. With them the time-honored
function of the doctor is to ap-ply
remedies, to diseases, and according
to the law of supply and demand, the
physician usually equips himself for the
performance of that function, and by so-licitation
and practice grows in that direc-tion.
It is not my purpose to derogate
this part of the physician's work. The
world would be much poorer without the
legitimate use of opium, chloroform,
eocain. quinine, iodine, mercury and
other remedies. If the evil is upon us,
that which removes or mitigates it will
continue to be appreciated and sought,
but where cure can save its thousands,
prevention can save its tens of thousands,
and it is a crying necessity to-day that
this fact receive both a theoretical and
practical realization by the whole people.
Before we can hope to leaven the whole
lump of the b> dy politic, let the phy-sician
scrutinize himself and the field that
he occupies, to see how far he is the ex-ponent
of the true science, or to what
extent he typifies or justifies a recent car-toon
that represents nature and disease in
fierce combat, while the doctor comes up
blind-folded, and with his cudgel strikes
risrht and left, now striking the disease
and now the patient.
The history of the application of ther-apeutic
measures (drugs mainly) does
much to justify this cartoon. It is not
necessary to more than refer to the incan
tations and other absurdities of ignor-ance
and superstition which were in keep-ing
with the dark ages in which they were
practiced. Within the memory of men
of to-day, famishing fever patients have
been deprived of water by their mis-guided
attendants, who were governed by
tradition and custom, rather than by the
dictates of common sense and the unerr-ing
cravings of nature. Even the foul
air of the patient's room was carefully
confined by closing the doors and win--
dows, and perhaps his strength still more
reduced by copious blood-letting.
My mother related to mean experience
in her earlv life. Her father, living on
his plantation, was stricken with (ever,
and after some days or weeks of bleed-ing
and famishing he died. A number of
his negro slaves were also stricken and
under the same management went the
same way. One servant begged to be let
alone and not subjected to the treat-ment.
His wishes were gratified and he
alone recovered. I remember the old
man well. He lived to advanced age.
BULLETIN OF THE NORTH CAROLINA BOARD OF HEALTH. 293
Homeopath}- and a number of other
pathies, in spite of their absurdities, had
fruitful soil in which to grow. They
were less aggressive on the persons of the
suffering sick, and if they gave no aid,
were not so likely to hinder natural re-coveries,
and so the regular profession
looked on, learning from experience,
grew in knowledge, by its natural evolu-tion,
and became wiser than their critics.
But the medical millenium has not yet
come, nor are the days of mal-practice
past. Even among operative procedures,
the fads of gynecologists and the ex-ploits
of those seeking fame by startling
measures in other fields require con-stantly
to be challenged, to show cau-e
why they should not be discontinued. If
the nov ce takts up an optimistic modern
work on materia medica, and studies the
physiological effect of drugs and their
therapeutic application, he might easily
be impressed with the belief that drugs
could control every pathological process,
and remove every morbid condition.
Coupled with these studies, he is very
much surprised to find that works on
practice of medicine (perhaps especiallv
those of the scientific Germans ) will give
exhaustive descriptions of disease, path-ology,
etiology, clinical history, diagno-sis
and prognosis, but beyond general
reference to hygiene, nothing specific as
to the treatment. Tne fact of the lim-ited
power of drugs to work beneficial
changes begins to dawn upon him, and
that even those that are of undoubted
value are like edged tools, and require
careful handling. Even our compara-tively
harmless quinine, which so effect-ually
destroys the malarial plasmodium,
has been made to do its share of harm.
On no less authority than the German
professor, Leibermeister, 40 grains at a
dose have been given to typhoid patients.
Within recent years the coal tar antipy-retics
were hailed with delight. Fever
killers had come at last! A Baltimore
professor told his class that antipyrine
was what he had been praying for. I
think you will agree with me that more
patients than fevers have been killed by
them ; and these remedies are in rather
common use among the laity.
Not many days aa;o I visited a child to
whom the mother had administered a
dose of acetanilid before the cold stage
of an intermittent fever had disappeared.
Alarming symptoms followed. Another
case came under my notice, where a far-mer
had administered a dose of acetani-lid
under similar circumstances. The
child died, apparently from its effects.
Not many years ago, the doctrine was
promulgated that disease, a condition of
lowered vitality, required to be combat-ted
by copious administration of alco-holics.
This fascinating theorv had
many adherents and did much harm. In
the field of dietetio, we went from star-vation
to stuffing. Even to-day an Amer-ican
text-book advises that a tvphoid
fever patient may take as much as six
quarts of milk a day. a quantity that has
been shown by physiological experiment
to be one-third more than the full diges-tive
capacity of a healthy man, eating
nothing else and digesting all the day.
We have no infallible guides. Our rea-son
must challenge every theory, and our
experience prove all things, and hold fast
to that which is good.
But why this arraignment of a profes-sion,
which in the matter of education,
conscientiousness and faithfulness com-pare-!
favorably with any on earth. It is
tD lament that our most uncertain and
dangerous functions are most in demand ;
that millions ol dollars are paid by the peo-ple
for the practice of medicine as it is
being done, and as to some little extent
has been indicated in the foregoing pages,
while our best functions or capabilities
are dwarfed by disuse and neglect. The
public health officer would have to be a
missionary at his own expense, while a
premium is put on disease. This is not a
mere perverse and unnatural choice of
the people. They are as wise as we are,
and will seek their own good as they con-ceive
it to be. We are of them, and dif-fer
only as regards these matters in
knowledge.
If they, the masses of the people, knew
as much of the sources of the disease as
the educated better element of physicians,
who do you suppose would be in the van
of the procession to stamp it out? The
man who reaps a harvest when disease
runs riot, or the man who pays the bill.-?
That the people should become possessed
of this knowledge is the piime requisite,
for should we obtain such legislation as
in our judgment was all that was necessary
and such appropriation- aswould leave our
Board of Health unhampered in discharge
of their functions, the laws would be
largely inoperative if lacking in popular
2 94 BULLETIN OF THE NORTH CAROLINA BOARD OF HEALTH.
sympathy and support ; besides, many of
these things would depend on habits of
individuals, which legislation could not
control. It is to be, then, chiefly a mat-ter
of education; and how to accompliah
this, is the problem.
If the individual physician in his pro-fessional
and social contact with his cli-ents
sows the seed, if our Boards of Health,
local and State, continue and even im-prove
upon their good work, and if our
schools, from the lowest to the highest,
teach the rudiments of the science of
health, and unfold to the mind of the
pupil the necessity of expert work in the
prevention of disease, knowledge must
grow. And if our State Society, in its
organized capacity, with the courage of
its convictions, does not hesitate to urge
necessary legislation, they will have dis-charged
their dut)', and may soon accom-plish
much.
Tvphoid fever,which is perhaps entirely
ventable, causes the State the loss of
manv a victim and much treasure. Cur-rent
knowledge or opinion ascribes its
propagation almost entirely to intestinal
discharges of the infected. Prevention
would seem to be in easy reach, yet it
goes on. Personal observation leads me
to believe that disinfection of the dejec-tions
is not accomplished in one half the
cases. Man}- cases of continued fever are
not considered typhoid fever which are
most likely of that nature. I will not
discuss the subjt ct, but pass it by with
the recommendation that the dejections
of all fever patients be disinfected. The
pub'ic should be instructed to do so, even
where physicians are not employed, as
they often are not, and it may be a fit
subject for compulsory legislation. Our
Board of Health has done a good service-in
the matter of prevention of malarial
fevers by use of deep well and cistern
water. But a property managed cistern
is an exception. Infectious germs are
carried from the atmosphere or house-tops
to the cistern. Filters, often im-perfect,
remain unchanged until over-saturated.
They become thus the source
of infection. Tuberculosis continues to
be propagated by the expectoration of
the infected without hindrance, except
perhaps in one municipality in the State.
Milk is sold from any kind of cow which
will afford it. Diseased meats are sold
in the markets. Ice is imported from
impure sources and people believe that
freezing purifies it, which is true only to
a limited extent, and may be manufac-tured
from impure water. Any kind of
canned food is sold that any one will buy.
There is no check on adulteration or
fraud as to what the people eat or drink
or take as medicines, patent or proprie-tary,
save their own unskilled judgment,
warped or blinded by alluring advertise-ments
and unblushing false assertions.
The physician often finds that a patient
unable to pay him has raked up money
enough to pay an exorbitant price for
worthless medicines or appliances. Drug-gists
practise medicine. Spectacle ven-ders,
ignorant or unscrupulous, still prac-tice
this branch of the medical art,
though a medical college graduate has
first to pass our State Board. Danger-ous
drug habits or other evil conse-quences
arise from headache cures and
the like. Beverages (coca cola for in-stance)
sold from the soda fountains
should be subject to analysis and the peo-ple
advised, or the sale interdicted if nec-essary.
I refrain from further specific
references.
The doctor of the future will probably
differ more widely from the one of to-dav
than the doctor of to-day differs
from the one of the past. We know
something of him of the past and the
present, and that the tares have been
mixed with the wheat in varying propor-t
ons. With prophetic eye we may con-template
him of the future, but we know
not how far distant, or how near at hand.
The poet or philosopher may by inspira-tion
point the way, the scientist by ex-perimental
research may demonstrate.still
events occur only in the fulness of time
or that period in the evolution of the
human race under the sovereignty of God
when it is possible to achieve that which
before was not attainable, but thr sword
of the doctor (his weapons of %varfare on
disease or the diseased) will be changed
to the pruning-hook, which cuts away the
poisonous branches Lupon which grow
the deadly fruit.
In the propagation of the race, in the
construction of human habitations, in
clothing and in food, in labor and in rec-reation
there is a rational wisdom, and in
connection with these there should be
skilled advisers. If physic should be
thrown to the dogs, will the doctor's oc-cupation
be gone? Not when he has
proper surveilance over everything that
BULLETIN OF THE NORTH CAROLINA BOARD OF HEALTH. 295
affects the health of the people. In his
present status of equipment he could do
much more than he does or is permitted
to do, but when the new order of things
creates the demand, medical colleges will
not condone ignorance of chemistry and
physics, even as now imperfectly taught,
nor make side-shows of the microscope
and laboratory These stones, which are
well nigh rejected by the builders of med-ical
education, will become the heads pf
the corner. These things will be sine qua
non
.
North Carolina has been called the Rip
Van Winkle of States; still she has been
known to arouse from her lethargy. In
the matter of legislation regulating the
practice of medicine, she was ( through
the influence of our Society) in the van
of the procession. And in this historic
city (Mecklenburg County), May 20th,
1775, she sounded the bugle call as a pio-neer
of libertv. It is fitting that we
should here resolve to push still further
the lines of human progress.
REVIEW OF DISEASES FOR APRIL. 1898.
(SEVENTY-SEVEN COUNTIES REPORTING.)
Eighty-one counties have Superinten-dents
of Health.
Except in the case of the more conta-gious
and dangerous diseases, the Super-intendent
has, as a rule, to rely upon his
own information alone, since few physi-cians
can be induced to report cases of
non-contagious diseases to him.
Where the number of cases is not given,
or the prevalence of a disease otherwise
indicated, its mere presence in the county
is to be understood as reported.
For the month of April the follow-ing
diseases have been reported from the
counties named:
Measles — Alamance; Alexander, 1;
Beaufort, in all parts (100); Bertie; Bun-combe,
1 ; Catawba, many; Chowan, epi-demic
; Franklin, many; Haywood, ^:
Johnston ; Lincoln, 3; Martin, 2; Mont-gomery,
10; Pitt, widely prevalent in
southern part ; Randolph, 10; Robeson;
Rockingham, in all parts; Stokes, in all
parts. Wake, 19; Warren, several; Wash-ington,
2; Wilkes, 25; Wilson, 5; Yad-kin,
2; Yancey, a few—25 counti< s.
Mumps—Alamance; Jackson; Macon;
Mecklenburg; Union.
11 'hooping-cough—Chowan, epidemic;
Durham, 1; Granville; Greene, 50; Jack-son,
10; Mitchell, 40; Montgomery, 50;
New Hanover. 1; Onslow, 10; Randolph,
20; R.obeson; Wan en, several; Washing-ton,
70; Wayne, epidemic; _Wilkes, 15!
Yadkin, 12—16 counties.
Scarlatina—Buncombe, 1; mild, quar-antined,
recovered; Cumberland, 5 ; Rich-mond,
3.
Diphtheria—Jackson, 8.
Typhoid Fever—Alexander,!; Beau-fort.
3 ; Catawba, 2; Davidson, 1; Pitt,
Randolph; Robeson; Rowan; Sampson, a
few; Swain, 3; Union, 12—11 counties.
Malarial Fever—Columbus ; Gaston,
2; Sampson; Wilson.
Small-pox—Buncombe, 2.
Influenza— Mecklenburg; Transylva-nia.
Pneumonia — Mecklenburg; Orange;
Perquimans; Rutherford; Transylvauia;
Warren, Yadkin—7 counties.
Diarrheal Diseases—Cleveland; Gas-ton;
Hertford; Nash; Rutherford; Samp-son.
\'ar ice/la—Greene; Mecklenburg and
Wake.
Distemper in Horses—Lincoln.
Cholera in Hogs—Hertford; Macon.
No diseases of importance are reported
from Bladen, Burke, Cabarrus. Caldwell,
Cartaret, Chatham, Cherokee, Clay,
Edgecombe, Forsyth, Gates, Halifax,
Henderson, Iredell, McDowell, Madison,
New Hanover, Pasquotank, Pender, Per-son,
Polk, Surry and Watauga.
No reports have been received from
Anson, Craven, Duplin and Vance.
296 BULLETIN OF THE NORTH CAROLINA BOARD OF HEALTH.
Summary of Mortuary Reports for April.
1898 (Twenty-three Towns).
Only those towns from which certified
reports are received are included:
White. CoVd. Total.
Aggregate popula-tion
7 2 .439 55.S2I 128,260
Aggregate deaths . . 48 Si 129
Representing tem-porary
annual
death rate per
1,000 7-9 T 5-6 12.
1
Ca uses of Deo th
.
Typhoid fever 2 o 2
Malarial Fever. ... I 1 2
Whooping-cough..022
Measles o 1 1
Pneumonia 6 5 1
1
Consumption 9 19 28
Brain diseases 7 2 9
Heart diseases 2 5 7
Diarrhceal diseases 606
All other diseases . 1
5
42 57
Accident o 4 4
48 Si 129
Deaths under five
years 15 24 39
Still-born 1 19 20
BULLETIN OF THE NORTH CAROLINA BOARD OF HEALTH. 297
Mortuary Report for April, 1898.
Towns
298 BULLETIN OF THE NORTH CAROLINA BOARD OF HEALTH.
County Superintendents of Health.
Alamance Dr. J. K. Stockard.
Alexander Dr. T. F. Stevenson.
Alleghany
Anson Dr. E. vS. Ashe.
Ashe Dr. L. C. Gentry.
Beaufort Dr. D. T. Tayloe.
Bertie Dr. H. V. Dunstan.
Bladen Dr. Newton Robinson.
Brunswick Dr. D. B. McNeill.
Buncombe Dr. I. A. Harris.
Burke Dr. J. L. Laxton.
Cabarrus Dr. J. S. Lafferty.
Caldwell Dr. A. A. Kent.
Camden No Board of Health.
Carteret Dr. F. M. Clarke.
Caswell
Catawba Dr. F. L. Herman.
Chatham Dr. H. T. Chapin.
Cherokee Dr. S. C. Heighway.
Chowan Dr. R. H. Winborne.
Clav Dr. W. E. Sanderson.
Dr. R. C. Ellis.
Dr. J. F. Harrell.
Dr. L. Duffy.
. Dr. J.Vance McGougan.
No Board of Health.
Cleveland . . .
Columbus . .
Craven
Cumberland.
Currituck .
.
Dare
Davidson Dr. John Thames.
Davie Dr. James McGuire.
Duplin Dr. F. H. Arthur.
Durham Dr. John M. Manning.
Edgecombe Dr. L. L. Staton.
Forsyth Dr. John Bynum.
Franklin Dr. E. S. Foster.
Gaston Dr. J. H. Jenkins.
Gates Dr. R. C. Smith.
Graham No Board of Health.
Granville Dr. G. A. Coggeshall.
Greene Dr. Joseph E.Grimsley.
Guilford Dr. A. E. Ledbetter.
Halifax Dr. I. E. Green.
Harnett No Board of Health.
Haywood Dr. J. Howell Way.
Henderson Dr. J. G. Waldrop.
Hertford Dr. John W. Tayloe.
Hyde No Board of Health.
Iredell Dr. Henry F. Long.
Jackson Dr. William Self
.
Johnston ....
BULLETIN OF THE NORTH CAROLINA BOARD OF HEALTH. 299
[You are asked to rill out and mail one of these forms to rhe Superintendent of Health
of your County on or before the third of each month, that he mav use it in making his
report to the Secretary of the State Board]
Have any of the following diseases occurred in your practice during the month
just closed. If so, state number of cases.
Whooping-cough Typhoid Fever
Measles Typhus Fever ;
Diphtheria Yellow Fever
Scarlet Fever Cholera
Pernicious Malarial Fever — Small-pox
Hemorrhagic Malarial Fever Cerebro-spinal Meningitis
-
What have been the prevailing diseases in your practice ?
Has any epidemic occurred among domestic animals ? If so, what?
What is the sanitary condition of your section, public and private ?
Genera] Remarks
-M. I).
1S9 — N.C.
428-6-20-98-2400.
BULLETIN
OF THE
Itorth GaFolina Board of Health.
Published Monthly at the Office of Secretary of the Board, at Raleigh, Ar
. C.
Geo. G. Thomas, M. I)., Pres., Wilmington.
S. Westray Battle, M. D.,..Asheville.
W. H. Haerell, M. D., Williamston.
John Whitehead, M. D., ...Salisbury.
G. J. O'Hagax, M. D Greenville.
J. D Spicer, M. D Goldsboro.
J. L. NICHOLSON, M. D., Richlands.
A. \V. Shaffer. San Exg , Kaleigh.
RICHARD H. LEWIS, M. D., Secretary and Treasurer, Raleigh.
Vol. XIII. JUNE, 1898. No.
SMALLPOX IN NORTH CAROLINA.
Eleven cases reported in Statesville and
Belmont, a suburb thereof. All isolated
in pest hospital and eight about well.
Another case reported as present at Van-derborg's
Chapel. It is strictly quaran-tined.
There being a disposition on the part of
the people to break over the quarantine,
notwithstanding all the local physicians
were agreed as to the diagnosis, the Su-perintendent
of Health asked for an ex-pert
to be sent to back him up. In com-pliance
therewith we requested Surgeon
General Wyman, M. H. S, to send one.
Dr Wertenbaker was sent, and reports to
us that the outbreak is well managed by
the local authorities.
YELLOW FEVER.
We regret to note the recent restricted
outbreak of yellow fever in Mississippi.
The fears that owing to the mild winter
some of the germs of last summer might
be brought over seem to have been real-ized.
We shall watch the immediate fu-ture
with anxiety, but trust that it can be
kept within bounds.
THE PUBLIC WATER SUPPLIES OF THE
STATE.
At the annual meeting of the Board at
Morehead in June, 1897, "it was ordered
that the municipal water supples of the
State be examined chemically and bacte-riologically
during the current year; and
that the engineer of the Board be re-quested
at his convenience to collect,
pack and ship samples for the same, and
at the same time to make an inspection
and report on the various water works
and water sheds." Col. Shaffer having
carried out the above instructions, sub-mitted
his report to the recent meeting of
the Board in Charlotte—the first since
the completion of the work—and the Sec-retary
was ordered to publish it in the
Bulletin.
It may be remembered by some of our
readers that this work of systematically
investigating all the public water supplies
of the State was first undertaken in 1896,
and was limited to simply an analysis of
the water. While that examination was
very incomplete, owing to the extremely
small appropriation by the State, it un-doubtedly
had a good effect on the water
companies. We are all more particular if
12 BULLETIN OF THE NORTH CAROLINA BOARD OF HEALTH.
we know we are watched. Realizing this,
the Board felt that some of its little money
could not be put to a better use, and so
the action indicated above was taken.
The reader will understand, of course,
that we do not suppose that an annual in-spection
and analysis will make pure
water, but it will make for purer water by
causing the water companies themselves
to take a more active interest in the mat-ter.
Neither would any number of analy-ses
insure pure water, for the reason that
it must be already infected before the
pathogenic bacteria can be found. Fre-quent
inspections of the water shed, how-ever,
and thorough filtration would be
much more effective. It is far safer and
easier to prevent disease germs from get-ting
into the water than to get them out
after they have taken possession. And
inasmuch as a number of our supplies are
taken from small streams whose restricted
water sheds are inhabited, the danger of
infection is much greater than where the
origin of the supply is different. After a
careful consideration of the matter, we
have come to the conclusion that the best
thine water companies obtaining their
supply from such water sheds can do to
insure the purity of their water, is to em-ploy
some reliable man whose sole duty
it shall be to thoroughly patrol the water
shed, going over it and visiting every resi-dence
thereon at least twice a week, and
promptly reporting every case of fever or
diarrhoeal disease, that it may be immedi-ately
investigated and such precautions
taken as may be necessary. We are glad
to say that this suggestion made in a con-versation
with one of the owners has al-ready
been adopted by the Charlotte
Water Company. If this thorough and
continuous inspection should be supple-mented
by approved filtration, we be-lieve
that the danger of infection would
be reduced to a practical minimum. It is
apparent, we think, that it would be
clearly to the interest of the water com-panies,
for the occurrence of typhoid fe-ver
traceable to their water would reduce
their receipts far more than carrying out
the above suggestion for a number of
years. Besides, the effect of such careful
protection of the watei against infection
would give confidence to the people, and
would be immediately and continuously
beneficial to their business.
The reader of the report will doubtless
be struck with the high price charged for
water, especially to small consumers,
which, of course, includes all the poorer
classes. In several instances a minimum
consumption amounting to $12 per an-num
is required, which is practically pro-hibitory
to the poor. While no doubt
some of the companies find it a hard mat-ter
to "make buckle and tongue meet,"
this should not be. We have no control
over the price charged, but we feel it our
duty to say that high-priced water is not
in the interest of public health. Pure
water in abundance, at a price within the
reach of all, is one of the most powerful
agencies for promoting the health of any
community. It is for this reason that we
believe so strongly in municipal owner-ship.
We cannot expect those who have
invested their money in such enterprises
for the purpose of securing dividends to
look at the matter from the eleemosynary
point of view—they have a right both in
law and equity to make such charges as
will insure them a reasonable return on
their investment. But when the water
works are owned by the people as a whole
the object of the management will not be
dividends but health, comfort, beauty and
safety from fire. The general tendency is
towards municipal ownership, and we
trust that it will spread in North Caro-lina.
It pay=. Wilson owns its own
work and sells water at ten cents per
1.000 gallons at a profit.
It should be noted in connection with
BULLETIN OF THE NORTH CAROLINA BOARD OF HEALTH. 13
the chemical analyses that where the al-buminoid
ammonia is too high, that it is
nearly always due to vegetable matter in
the stream in the form of leaves, etc., and
that it is not dangerous in itself. In re-gard
to the bacteriological tests, it should
be said that while the}- are not as elabo-rate
and complete as they might be, they
are made by good men and are carried
far enough to show whether or not there
is reason to suspect the water of being in-fected
.
In conclusion, we wish to put ourself
on record as favoring the use of public
water supplies as against the water of
wells, provided the companies will con-scientiously
use every reasonable effort to
insure the purity of their supplies. The
water of the public supply may some-times
be dangerous, but that from wells
in closely-built cities and towns with sur-face
privies, and more especially cess-pools,
is much more apt to be so.
The chemical analyses were all made
for us without charge by the N. C. Agri-cultural
Experiment Station, and we de-sire
to make our acknowledgments to
Acting Director Withers for his valuable
aid in this respect.
The comments on all chemical analyses
are made by the chemist.
Report of Col. A. W. Shaffer, En-gineer
of The Board.
Goldsboro, August 3, 1897.
One sample taken from intake on Little
river at the power house, and one from
the tap in front of Hotel Kennon, on
Railroad street, both for bacteriological
analysis, taken, packed and delivered to
Dr. Anderson, of Wilson, in his presence.
Samples for chemical analysis have been
since procured by yourself.
This visit to Goldsboro has been fully
reported heretofore.
The following is the report referred to :
"I reached the city about noon, and
was glad to find awaiting me, the Presi-dent,
Dr. Geo. G. Thomas, and the Biol-ogist,
Dr. Anderson, Drs. Spicer and
Hill conferring with us cordially.
We visited the water works on Little
river in company with the mayor, and
found the works small, but filter working
well, and supply tinted with the juniper
and cypress, through which it passes, but
clear, and free from green scum, bad odor
or taste, which had been reported to ex-ist
there. We took samples from the in-take
and returned to the city ; took an-other
from the tap in front of Dr. Hill's
drug store, in the hotel building, and Dr.
Anderson packed both in ice and carried
them with him that night to Wilson.
Through the courtesy of the mayor we
were enabled to ride over the town and
view its water-shed and drainage. We
found no sewers, but we never saw a town
so well adapted by nature for efficient
sewering at a moderate expense—say
Waring's system. There is ample grade
and fall in every direction, with no rock
or hard subsoil to penetrate, and would
discharge into Neuse river within a mile
of the corporate limits, two to three
miles below the intake on Little river.
The water-bearing strata of Goldsboro
lies barely ten feet below the surface, and
in wet seasons the water in the wells
rises to within four to six feet of the sur-face.
The waste water of the town emp-ties
into shallow surface ditches, and is
liable to percolate through the sandy
crust to the wells, from which a large ma-jority
of the citizens of Goldsboro obtain
their water for all purposes.
I think that so tar as the health of the
town is concerned, there is greater dan-ger
than with no water works, because of
the lack of sewerage, to carry off the
waste.
Brifly stated, Goldsboro is situated upon
a plateau of open, sandy loam, elevated
about twenty feet above, and distant
14 BULLETIN OF THE NORTH CAROLINA BOARD OF HEALTH.
about one mile from Little river on the The chemical analysis indicates that
northwest, and Neuse river on the south, this is not a good water for drinking pur-
The water-bearing strata under the town poses.
averages eight to twelve feet below the bacteriological examination' by dr.
surface, and there are localities in which Anderson.
the well water can be reached from the Qne sampie ^ unfiltered, was collected
surface with a long-handled gourd. Hav- from the jntake at the river. This
ine no sewers, the city is drained by shal-sh
wed 300 ba teria to the C. C. of benign
low surface ditches, alternately wet and
form The other sample, filtered, was
dry from atmospheric causes; always collected from a faucet on Railroad
more or less charged with the waste and street and this contained only 53 bacteria
sewage of buildings, and the use of the to the c q The last sampi e represents
street and lawn taps connecting with the the water used Dv the city which is good.
river supply, the shallow wells beine the
common receptacle and reservoir of all. Wilson, Nov. 8, 1897.
If typhoid germs breed and multiply Two sampies taken from tap in drug
under the=e conditions, then Goldsboro store acjjoining Dr. Anderson on Main
is an ideal propagating ground, though street—one delivered personally to Dr.
the waters at the intake be as pure and Anderson and the other sent to Experi-limpi
i as those of Pi*on, Gihon or Hid- ment Nation at Raleigh.
ekel, that sprang from the garden of Visited power-house, intake and water-
God, shed with Dr. Anderson. These are
Works belong to private parties, who aDOut a mile from town. The works
sell water to small consumers at 40 cents have no filter and the town no sewerage,
per 1,000 meter gallons." The intake is abut one hundred yards
N. B.—Since the above report was from trie works, on the run of Toisnot
made the people of Goldsboro have voted swanlp) with a flow of water over the
bonds for sewering the city. £am ten inches deep and twelve feet
chemical analysis. wide, clear, but full of floating leaves,
Sample from Intake and tinted slightly by decaying vegeta-tion.
The canal draining the swamp is
Total solid matter -
and the area of
in solution 3.3 er. per U.S. gal. '
Hardness 1.4 deg. Clarke's sc. the swamp about one and a half square
Equiv. to cal. car. 0.33 gr. per U.S. gal. miles, with ever recurring living springs
Chlorine 0.33 gr. per U.S gal. aiong jt s margin—a very slight run cross-
Fr« e ammonia 106 parts per mil m thg intake If
Album'd ammonia. 0.170 parts per mil. * *•... ,_, , • „ „j
an open, dry ditch could be maintained
The chemical analysis indicates thit aroUnd the margin of the swamp, the
this is not a good water for drinking pur- banks f the canal and the run of the
poses. swamp cleared—say twelve feet wide on
Sample from Faucet in City. each side—and the run of the swamp
Total solid matter opened and kept clear from dead leaves,
in solution 3.3 gr. per U. S.gal. falling branches, trunks of rotten trees
Hardness 14 deg. Clarke's sc. an d water-grasses that obstruct the flow,
Equiv. to cal. car. 3.3 gr. per U.S. gal. they would have as near an ideal reser-
Chlorine. . . . 0.33 gr per U S gal. ^afford>
Free ammonia. ... 0.043 parts per mil. **
Album'd ammonia, 0.232 parts per mil. The works are owned and operated by
BULLETIN OF THE NORTH CAROLINA BOARD OF HEALTH. 1
5
the town; sell water to small consumers
at ten (10) cents per 1,000 meter gallons,
and realize a profit upon the cost of plant
and its operation.
CHEMICAL ANALYSIS.
Total solid matter
in solution 3.83 gr. per U.S. gal.
Hardness 1.7 deg. Clarke's sc.
Equiv. to cal. car. 0.58 gr. per U.S. gal.
Chlorine 0.33 gr. per U.S. gal.
Free ammonia . . 0.0449 parts per mil.
Album, ammonia 0.2155 parts per mil.
The high percentage of albuminoid
ammonia indicates vegetable contamina-tion.
BACTERIOLOGICAL EXAMINATION BY DR.
ANDERSON.
The bacteriological examination of
sample of water collected from the Wil-son
public water supply, November 10th
1S97, showed 150 bacteria to the C. C.
All tests used in making the examination
showed the water good.
Newbern, Nov. 10, 1*97-
Took two samples water from the run-ning
public hydrant at the corner of
Main street, near vhe Hotel Chattawka
;
one sent to Dr. Anderson at Wilson, the
other to Experiment Station at Raleigh.
Water derived from six bored, or ai tesian
wells ; no water-shed or filter. Works
owned and operated by private corpora-tion,
and water sold to small consumers
at 50 cents per 1,000 meter gallons, with
a minimum of 100 gallons per day.
CHEMICAL ANALYSIS.
Total solid mat-ter
in solution, 10.25 gr.per U.S. gal.
Hardness 10.01 deg. Clarke's sc.
Equi.tocal. car. 7.68 gr. per U.S gal.
Chlorine 0.5 gr. per U.S gal.
Free ammonia. . 0.0100 parts per mil.
Alb. ammonia.. . 0.020 parts per mil.
There is no indication of organic con-tamination.
BACTERIOLOGICAL EXAMINATION BY DR.
ANDERSON.
The sample of water received from the
Newbern public water supply, Novem-ber
10th, 1897, showed only S3 bacteria to
the C.C. in making a bacteriological ex-amination.
All tests used show this
water to be very good.
Wilmington, Nov. 11, 1897.
Took two samples water from tap in
Mr. Munds' drug store on Main street;
packed, addressed and deposited them in
express office, and withdrew them after
conference with and upon advice of the
President of the Board, to be retaken
upon the completion of the artesian well
now boring upon the site of the power-house,
or other production of acceptable
water.
Owing to the liability of infection by
the city sewage in the ebb and flow of the
tide, it is earnestly recommended that the
intake be removed above tide water in the
event of the failure of the artesian well
now boring.
The works are owned and operated by
private parties, and the water is sold to
small consumers at twenty cents per 1,000
meter gallons.
FayettevillE, Nov. 12, 1S97.
Two samples of water taken from the
running public hydrant at the corner of
Hotel Lafayette on Main street. One to
Dr. W. T. Pate, at Gibson Station, and
the other to the Experiment Station at
Raleigh.
This water is derived from the great
spring on Haymount Hill, and used for
drinking purposes chiefly. Other water
is taken from the run of Cross Creek, used
for general purposes, and for drinking
where Haymount water cannot be ob-tained.
No sample taken from Cross
Creek water.
The works are owned and operated by
i6 BULLETIN OF THE NORTH CAROLINA BOARD OF HEALTH.
private parties, and the water sold to
small consumers at twenty-five cents per
1,000 meter gallons, but not less than $1
per month.
CHEMICAL ANALYSIS.
Total solid matter
in solution 2.83 gr per U.S. gal.
Hardness 1.8 deg. Clarke's sc.
Equiv. to cal. car. 0.67 gr. per U.S. gal.
Chlorine 0.5 gr. per U.S. gal.
Free ammonia. . . . 0.061 parts per mil.
Alb. ammonia. . . . 0.0375 parts per mil.
The chemical examination shows no in-dication
of organic contamination.
BACTERIOLOGICAL EXAMINATION BY DR.
PATE.
The quantitative analysis gave 180 bac-teria
per cubic centimeter. The qualita-tive
tests showed no suspicious organisms.
Sample good.
Asheville, Nov. 19, 1897.
Two samples taken from tap in Ashe-ville
hotel. One to Dr. Albert Anderson.
at Wilson, the other to the Experiment
Station, Raleigh.
Through courtesy of Dr. Fletcher, vis
jted the filter within the city, the stand-pipe
and reservoir on Beaucatcher moun-tain,
and the power-house and intake five
miles out on the left bank of Swannanoa
river. This is the best plant in the State.
Four large filters are enclosed in brick
walls ; the reservoir is an abandoned rock
quarry, cleaned out and cemented, safe
against the intense cold that destroyed
the stand-pipe a few years ago, and the
power-house, dam and forebay are of
solid rock masonry. The water is con-ducted
to the city through two lines of
pipes, one ten and the other sixteen inches
in diameter, over two mountain spurs into
the stand-pipe and the reservoir.
This most expensive of the municipal
water works of the State is the property
of the city of Asheville, selling its water
to small consumers at fifteen cents per
1,000 meter gallons, and supplying the
street sprinkling, the sewer flushing, the
public, hydrants and the public fountains
free.
The only settlement on this water-shed
is at Black Mountain, sixteen miles away,
and very small.
CHEMICAL ANALYSIS.
Total solid matter
in solution ... . 2.16 gr. per U.S. gal.
Hardness 1.4 deg. Clarke's sc.
Equiv. to cal. car. 0.33 gr. per U.S. gal.
Chlorine 0.16 gr. per U.S. gal.
Free ammonia. . . . 0.013 parts per mil.
Alb. ammonia. . . . 0.0325 parts per mil.
A very pure water.
BACTERIOLOGICAL EXAMINATION BY DR.
ANDERSON.
The sample from the Asheville public
water supply was received November 20,
1897. In the bacteriological analysis of
this water no harmful bacteria were
found.
Charlotte, Nov. 22, 1S97.
Took two samples water from the run-ning
tap at Van Ness' grocery on Nnrth
Tryon street. One to Dr. W. T. Pate,
Gibson Station, the other to Experiment
Station, Raleigh.
By courtesy of Dr. Brevard, joint owner
with Mr. Eli Springs, I visited the power-houses,
reservoirs and part of the water-shed.
The latter consists largely of culti-vated
land. Not a favorable water-shed
for first-class water without thorough fil-tration.
There are. however, four filters
in use. The supply is derived from two
streams. Both average about one and a
half miles from the principal square in
town at the intersection of Trade and
Tryon streets. Both are conducted to a
settling basin near the power-house, from
which the water is conveyed to the filters.
This plant is owned and operated by
private parties, and water is sold to small
BULLETIN OF THE NORTH CAROLINA BOARD OF HEALTH. I
J
consumers at fifty cents per 1,000 meter
gallons. There exists an inchoate con-tract
for the sale of the plant to the city.
Note.—The management proposes to
reduce the rent to private consumers.
CHEMICAL ANALYSIS.
Total solid matter
in solution 5.91 gr. per U.S. gal.
Hardness 3.8 deg. Clarke's sc.
Equiv. to cal. car. 2.33 gr. per U.S. gal.
Chlorine 0.416 gr. per U.S. gal.
Freeammonia 0.36 parts per mil.
Alb. ammonia 0.1877 parts per mil.
The chemical analysis indicates vege-table
organic contamination.
BACTERIOLOGICAL EXAMINATION BY DR.
PATE.
The quantitative examination gave 425
bacteria to the cubic centimeter. This
sample forms gas in both glucose and lac-tose
bouillon, but I did not succeed in iso-lating
the fermenting bacteria.
SECOND BACTERIOLOGICAL EXAMINA-TION
MADE FOR WATER COMPANY
BY DR. PATE.
I have the honor to report as follows on
sample of water sent me from the public
water supply of Charlotte June 2, 189S
:
Sample shipped without ice.
It is clear—no sediment.
Contains only 120 bacteria to the cubic
centimeter of water. No fermentation in
lactose or glucose bouillon, even after sev-eral
days' growth.
This analysis indicates a safe drinking
water.
Concord, Nov. 23, 1S97.
Two samples of water taken from tap
at Marsh's drug store in presence of May-or
Crowell—one to Dr. W. T. Pate at
Gibson Station, the other to Experiment
Station at Raleigh.
Visited power-houses (two—both inside
city) with Mayor Crowell. The city is
built upon the crest of a long ridge, and
the supply of one station is taken from
the Reed Gold Mine shaft on one water-shed,
and the other from surface springs
on the opposite side, both very exactly
on the water-shed of the town. At the
first I found a pond of perhaps an eighth
of an acre, about a hundred feet above
the shaft, the overflow passing the station
within ten or twelve feet. On the other
water-shed, directly opposite, was the
other power-house, beside a walled and
covered spring.
The power-house contained a small
Worthington pumping engine, furnishing
power to run the pump and the electric
light plant of the town.
The Concord plant is owned and oper-ated
by a private party ; has a stand-pipe,
but no reservoir or filter, and the water is
sold to small consumers at 50 cents per
1,000 meter gallons.
CHEMICAL ANALYSIS.
Total solid matter
in solution 9.66 gr. per U.S gal.
Hardness 6.1 deg. Clarke's sc.
Equi. to cal. car. 4.25 gr. per U.S. gal.
Chlorine 1.16 gr. per U.S. gal.
Free ammonia . . 0.0449 parts per mil.
Album, ammonia, 0.05 parts per mil.
The chemical analysis does not show
any indications of organic contamination.
BACTERIOLOGICAL EXAMINATION BY DR.
PATE.
The quantitative examination gave 350
bacteria to the C. C. This water fer-ments
both glucose and lactose at 42 de-grees
in 36 hours. Quantity of bacteria
low—quality suspicious.
SECOND INSPECTION.
Concord, May 5, 1898.
I have the honor to report that pursuant
to the direction of the Board, made at
Charlotte conference on the 4th inst, I
visited Concord, N. C, and took new
l8 BULLETIN OF THE NORTH CAROLINA BOARD OF HEALTH.
samples of the municipal water, one for
the North Carolina Experiment Station,
at Raleigh, the other for Dr. W. T. Pate,
Biologist, Gibson, N. C, forwarding same
to each on the 5th inst.
I also visited and carefully inspected
the pump-houses and water-sheds of the
two stations, from which ihe water is ob-tained,
in company with Mayor Crowell
and the owner, Mr. F"etzer.
I found the ground about the walled
spring, had been raised about the
spring and graded off so as to make a
water-shed of about fifty (50) feet all
around it, and the surface was clear and
free from grass and weeds, but not in-closed.
Some additional machinery, of
an improved pattern—mostly electrical
—
had been placed in the power-house, but
no closet or stables had been removed
from the water-shed. Mayor stated,
however, that an ordinance removing
them to go into effect June 1st, had been
passed.
At the station on the opposite side of
the ridge on which the town stands,
known as the Reed Gold Mine Shaft Sta-tion,
I found the pump and connecting
pipes repaired and the pond freshly
drawn off. Another dam had been con-structed
across the run of the spring about
two hundred and fifty (250) feet above
the shaft- covering an area of about
3, coo feet—the overflow of which was
carried by a side-hill ditch to a wooden
box receptacle about fifty (50) feet from
the power-house, to be utilized for street
sprinkling, the sprinklers taking it di-rect
from the box.
The water-shed of this station is exactly
as I found it in November last—barring
the change of the pond. No closets or
stables have been removed. All of the
stables, and most of the closets discharge
upon the surface, but others discharge in
unwalled and uncemented pits and "old
wells," the latter of which are presumed
to connect directly with the water-bearing
strata within a radius of three hundred
yards of the pumping stations.
Mayor Crowell is deeply intetested in a
plentiful supply of pure wuter and a
limited sewerage within the financial ca-pacity
of the town. He afforded me
ever}' possible facility for inspection and
stated that the town council had lately
adopted an ordinance for the removal of
the closets and stables from the water-shed,
and assured me that if not rescinded
at a subsequent meeting, he would see
that the pits and vaults, after cleaning,
should be well limed before filling, but
the measure had met strong opposition,
and there was danger of a reconsideration
and rescinding of the ordinance before it
goes into effect on June 1, 1898. I saw
and conversed with some of the members
of the town council, and gathered from
their remarks that while all wanted pure
water and plenty of it, they were disin-clined
to credit the contamination theory,
and feared a "job," by which oppressive
taxes would be inflicted without corres-ponding
benefits. The wells on the di-viding
ridge are about forty feet in depth.
How they will cleanse and purify those
used for closet vaults, or whether they
will fill them up without cleaning, or
continue their use as heretofore—is yet an
unsolved problem. I regret to have to
state that the situation at Concord is not
greatly improved from the situation of
my November report, and I doubt
whether it will be greatly improved until
the water supply is taken from a source
above and beyond the town limits. The
mayor assured me that such a source ex-isted
about two miles out, with ample
supply for many years of rapid annual in-crease.
BULLETIN OF THF NORTH CAROLINA BOARD OF HEALTH. 19
CHEMICAL ANALYSIS.
Total solid matter
in solution .... 9.58 gr. per U.S. gal.
Hardness 3.6 deg. Clarke's sc.
Equi. to eal. car. 2.16 gr. per U.S. gal.
Chlorine o 79 gr. per U.S. gal.
Free ammonia . . 0.0073 parts per mil.
Album, ammonia, 0.0175 parts per mil.
A very pure water.
BACTERIOLOGICAL EXAMINATION BY DR.
PATE.
Sample of water collected may 5th,
1898, by A. W. Shaffer, S. E., from tap at
Johnson's drug store, Concord, N. C.
This sample contains only 92 bacteria to
the C. C. of water. No fei mentation in
lactose or glucose bouillon in 4S houis.
This indicates fair drinking .water, and
is by far the best sample that we have
had from this supply.
Salisbury, Nov. 24, 1897.
Took two samples water from flowing
hydrant of E. K. James, on Inniss street.
One to Dr. Albert Anderson, at Wilson,
the other to Experiment Station, Raleigh.
Water derived from Cane creek, rising
about six miles above town and flowing
along the base of Dunn's mountain, from
which a large part of its water comes.
Water-shed, cleared land on one side and
mountain growth on the other. No resi-dential
obstructions.
Power-house and intake two miles out;
stand-pipe in town; no sewerage; pump
run by Worthington engine; no filter; all
in good condition. E. B. Neave, Super-intendent.
Plant owned and operated by private
parties, and water sold to small consumers
at thirty cents per 1,000 meter gallons.
chemical analysis.
Total solid matter
in solution 9. 16 gr. per U.S. gal.
Hardness 3.8 deg. Clarke's sc.
Equiv. to cal. car 2.33 gr. per U.S. gal.
Chlorine 1.66 gr. per U.S. gal.
Free ammonia. . . . o 0566 parts per mil.
Alb. ammonia. . . . 0.0725 parts per mil.
The chemical analysis does not give any
indications of organic contamination.
bacteriological examination by dr.
anderson
In the bacteriological analysis of sam-ple
of water sent from Salisbury, received
on the 26th of November, there were re-vealed
some bacteria of a suspicious na-ture.
There were 1S0 bacteria to the cu-bic
centimeter.
Greensboro, Nov. 25, 1S97.
Took two samples water from running
tap at Holton's drug store in Hotel
McAdoo building on Main street. One
sent to Dr. Albert Anderson, at Wilson,
the other to the Experiment Station,
Raleigh.
Thanksgiving Day; everybody gone a
birding; did not go to plant or water-shed.
Couldn't find anybody who knew any-thing
about it.
Plant owned and operated by private
parties, and water sold to the small con-sumers
at forty cents per 1,000 meter gal-lons.
CHEMICAL ANALYSIS.
Total solid matter
in solution 5.66 gr. per U.S. gal.
Hardness 3.4 deg. Clarke' ssc.
Equiv. to cal. car. 2.0 gr. perU.S gal.
Chlorine 0.25 gr. per U.S. gal.
Free ammonia. . . . 0.0126 parts per mil.
Alb. ammonia . . 0.0737 parts per mil.
The chemical analysis does not give any
indication of organic contamination.
BACTERIOLOGICAL EXAMINATION BY DR.
ANDERSON.
On November 26th I received sample of
water from the Greensboro public water
supply. The bacteriological analysis
showed 150 bacteria to the cubic centime-ter.
This water is good.
Winston, Nov. 26, 1897.
Took two samples from public hydrant
in City Hall—one sent to Dr. YV. T. Pate,
20 BULLETIN OF THE NORTH CAROLINA BOARD OF HEALTH.
Gibson Station ; the other to Experiment
Station, Raleigh.
Supply derived from two springs. No
water-shed ; no filter and no sewerage.
Plant owned and operated by private
parties and water sold to small consumers
at 40 cents per 1,000 meter gallons. Rained
all day. No ice accessible.
CHEMICAL ANALYSIS.
Total solid matter
in solution. . . . 4.0S gr. per U. S gal.
Hardness 2.1 deg. Clarke's sc.
Equi. to cal. car. 0.91 gr. per U.S. gal.
Chlorine 0.766 gr. per U.S. gal.
Free ammonia . . 0.0233 parts per mil.
Album, ammonia, 0.0435 parts per mil.
The chemical analysis gives no indica-tion
of contamination.
BACTERIOLOGICAL EXAMINATION BR DR.
PATE.
Shipped without ice. The quantitative
examination gave 880 bacteria to the cubic
centimeter.
The qualitative examination reveals no
suspicious bacteria.
Salem, Nov. 26, 1897.
Took two samples water from tap at
Dr. Shaffner's drug store, on Main street
—one for Dr. W. T. Pate at Gibson, the
other to Experiment Station, Raleigh.
Water supply derived from springs in
southwest part of town.
No water-shed, no filters and no sewer-age.
Plant owned and operated by private
parties, and water sold to the small con-sumers
at 50 cents per 1,000 meter gal-lons.
Rained all day.
No ice accessible for bacteriological
specimen.
chemical analysis.
Total solid matter
in solution 5.08 gr. per U S. gal.
Hardness 1.9 deg. Clarke's sc.
Equi. to cal. car. 0.78 gr. per U.S. gal.
Chlorine. 1.25 gr. per U S. gal.
Free ammonia .. 0.24 parts per mil.
Album, ammonia, 0.1935 parts per mil.
The chemical analysis indicates that
this water is very dangerous. There
seems to be contamination from sewage.
BACTERIOLOGICAL EXAMINATION BY DR.
PATE.
The quantitative examination gave 1360
bacteria per cubic centimeter. This sam-ple
was sent by express without ice.
The qualitative examination gave no
indication of the presence of suspicious
organism.
As soon as the attention of the manage-ment
of the Salem Water Company was
called to the report of the State Chemist
on their water, they expressed their in-ability
to explain the apparent condition
of the water, and at once asked that four
new analyses, representing the four sources
of supply, be made. This was done, but
all four samples turned out chemically
excellent water. The apparent contami-nation
of the first sample has never been
explained. The following are the sup-plementary
analyses :
Total solid matter
in solution 2.92 gr. per U. S. gal.
Hardness .... 2.5 deg Clarke's sc.
Equi. to cal. car. 1.25 gr. per U. S. gal.
Chlorine 0.46 gr. perU. S. gal.
Free ammonia . . 0.051 parts per mil.
Album, ammonia, 0.050 parts per mil.
This sample shows no indication of or-ganic
contamination.
Total solid matter
in solution... 3.25 gr. perU.S gal.
Hardness 3.3 deg. Clarke's sc.
Equi. to cal. car. 1.92 gr. per U.S. gal.
Chlorine 0.67 gr. per U.S. gal.
Free ammonia.. . 0.0316 parts per mil.
Album, ammonia, 0.0500 parts per mil.
This sample shows no indication of or-ganic
contamination.
Total solid matter
in solution 3.17 gr. per U.S. gal.
Hardness 2.3 deg. Clarke's sc.
Equi. to cal. car. 1.08 gr. per U.S. gal.
Chlorine 0.25 gr. per U.S. gal.
Free ammonia.. . 0.0500 parts per mil.
Album, ammonia, 0.0487 parts per mil.
BULLETIN OF THE NORTH CAROLINA BOARD OF HEALTH. 21
This sample shows no indication of or-ganic
contamination.
Total solid matter
in solution 1.17 gr. per U.S. gal.
Hardness 1.8 deg. Clarke's sc.
Equi. to cal. car. 0.67 gr. per U.S. gal.
Chlorine 0.208 gr. per U.S. gal.
Free ammonia... . 0.044 parts per mil.
Album, ammonia, 0.0312 parts per mil.
This sample shows no evidence of or-ganic
contamination.
Durham, December 2, 1897.
Took two samples water from flowing
public hydrant, corner Cochrane and
Main streets. One to Dr. Albert Ander-son,
Wilson, the other to Experiment Sta-tion,
Raleigh.
Water supply taken from a stream nine
miles out, at its junction with Eno river.
Reservoir five miles out. Filter and sew-erage
here. Did not visit water-shed, as
it would consume another day.
Works owned and operated by private
parties, who sell water to small consumers
at twenty-five cents per 1,000 meter gal-lons,
or $3 per quarter with privilege of
12,000 gallons.
CHEMICAL ANALYSIS.
Total solid matter
in solution 3.67 gr. per U.S. gal.
Hardness 1.9 deg. Clarke's sc.
Equiv. to cal. car.. 0.75 gr. per U.S. gal.
Chlorine 0.275 gr- per U.S. gal.
Free ammonia 0.173 parts per mil.
Alb. ammonia .... 0.0505 parts per mil.
While the chemical analysis will not
condemn this water, it places it under sus-picion
of being contaminated with organic
matter.
BACTERIOLOGICAL EXAMINATION BY DR.
ALEXANDER.
There were 316 bacteria to the cubic
centimeter found in sample of water from
Durham public water supply, received and
put in culture December 3, 1897. The
water is fairly good.
Henderson. December 3, 1897.
Took two samples water from running
public hydrant on public square. One
sent to Dr. W. T. Pate, Gibson Station,
the other to Experiment Station, Raleigh.
Water taken from wells; no water-shed,
no filter and no sewerage.
Plant owned and operated by private
parties, and water sold to small consumers
at forty cents per 1,000 gallons meter
measure.
CHEMICAL ANALYSIS.
Total solid matter
in solution 3.25 gr. per U.S. gal.
Hardness 1.5 deg. Clarke's sc.
Equiv. to cal. car.. 0.42 gr. per U.S. gal.
Chlorine 0.25 gr. per U.S. gal.
Free ammonia. . . . 0.067 parts per mil.
Alb. ammonia. . . . 0.02037 parts per mil.
BACTERIOLOGICAL EXAMINATION BY DR.
PATE.
The quantitative examination gave 184
bacteria per cubic centimeter. The quali-tative
tests indicate safe drinking water.
Raleigh, December 7, 1897.
Two samples water taken from running
public hydrant in front of Metropolitan
Hall on Fayetteville street. One to Dr.
Albert Anderson, at Wilson, the other de-livered
in person to Experiment Station,
Raleigh.
Water supply taken from Walnut creek,
one mile south of city. Intake a mile
above, and a fourth of a mile above Rham-katte
road. Stream rises at Cary, eight
miles west of city. Water-shed visited,
inspected and fully reported on hereto-fore.
Condemned Yates dam still domi-nates
the waters. The company filter
their water, and the city is sewered.
Plant owned and operated by private
parties, who sell water to the small con-sumers
at forty cents per 1,000 meter gal-
22 BULLETIN OF THE NORTH CAROLINA BOARD OF HEALTH.
Ions, conditioned that it amount to $12
per annum, or 30,000 gallons per annum.
DETAILED REPORT OX WATER-SHED.
'
' I have the honor to report upon the
water-shed of the Raleigh water com-pany,
visited and inspected in company
with Dr. James McKee, Superintendent of
Health of the city; W. M. Russ, Mayor,
and Alex. M. McPheeters on the part of
the company, on the 24th inst. Com-mencing
at Cary, we found two open, un-boxed
privies on the bank of the main
ditch, and a pig-pen on another, the con-tents
of the latter flowing directly into the
main ditch at a distance of about 200 feet.
The main ditch contained a very slight
run of water, the product of a heavy
shower the previous night. There is no
living tributary at Cary, the ditch carry-ing
no water except surface water during,
and a few hours after, a storm—twenty-four
hours after which it is as " dry '
' as
the town ordinance. The first evidence
of a living stream appears about a mile
below the town.
We found all the streams running
muddy water from the rains of the pre-vious
night, until we reached the Hugh
Campbell spring branch, a bold, crystal
stream flowing from two fine springs on
the place.
'• The water-shed from Cary to Raleigh is
largely covered and protected by a natural
growth of forest and hedge, briars, cane
and shrub, and we found little to criticise
until we reached the "Little Yates
Mill," of L. D. Castlebury, on the Avent
Ferry road in Swift Creek township. The
dam of this mill backs water over five to
six acres, filled with mud and decom-posed
vegetation, with a rank growth of
grass, reeds, shrubs and weeds. As the
water is very shallow and the mud very
deep the site can be of no considerable
value for mill purposes, and afforded no
evidence of late use. Such a deposit in
the main run of the water supply must of
necessity contaminate the water that flows
from that point, creating a nuisance that
ought to be abated if possible.
" I am informed by Dr. McKee that this
dam was reported detrimental to the
health of the people of Raleigh and de-clared
to be a nuisance in December,
1S95. I have since found such report and
declaration, bearing date December 21,
1895, and signed by him officially as Su-perintendent
of Health of the city of
Raleigh, and the signature of Dr.
P. E. Hines, preceded by the fol-lowing:
' / endorse the above recom-mrndation.''
" The intake of the company is situated
upon the Grimes farm above the bridge
on the Rhamkatte road about a mile
southwest of the corporate limits of the
city. The surplus water flows over a nat-ural
ledge of gneissoid granite brought to
a dead level so as to carry off all floating
foreign matter at every point, airways pro-vided
it first escape the wide mouth of the
intake, set in the current and facing up
stream, like a saurian bobbing for flies. A
proper adjustment of this intake would
greatly relieve the filter at the pump-house,
and remove an ever-present source
of adverse criticism.''
CHEMICAL ANALYSIS.
Total solid matter
in solution 4.58 gr. per U.S. gal.
Hardness 2.1 ueg. Clarke's sc.
Equiv. to cal. car. 0.92 gr. per U.S. gal.
Chlorine 0.30 gr. per U.S. gal.
Free ammonia ...0.031 parts per mil.
Alb. ammonia. . . . 0.0787 parts per mil.
The chemical aualysis shows no indica-tion
of contamination from organic mat-ter.
BACTERIOLOGICAL EXAMINATION BY DR.
ANDERSON.
I found 240 bacteria to the cubic centi-meter
in sample from the Raleigh public
BULLETIN OF THE NORTH CAROLINA BOARD OF HEALTH. 23
water supply, some of which were of a
suspicious nature.
The order of the State Board of Health
is executed. All which is respectfully
submitted. A. W. SHAFFER, 5. E.
REVIEW OF DISEASES FOR MAY. 1898.
(SEVENTY-SIX COUNTIES REPORTING.)
Eighty-four counties have Superinten-dents
of Health.
Except in the case of the more conta-gious
and dangerous diseases, the Super-intendent
has, as a rule, to rely upon his
own information alone, since few physi-cians
can be induced to report cases of
non-contagious diseases to him.
Where the number of cases is not given,
or the prevalence of a disease otherwise
indicated, its mere presence in the count}'
is to be understood as reported.
For the month of May the follow-ing
diseases have been reported from the
counties named:
Measles.—Alexander, 7 ; Ashe, 4
;
Beaufort, 75 ; Buncombe, 1 ; Catawba,
numerous ; Chowan, many ; Davidson, 5 ;
Forsyth, in all parts ; Harnett, epidemic
in one section ; Johnston ; Moore, 75 ;
Orange, 1 ; Pitt ; Rockingham, a few ;
Vance, 4 ; Wake, 4 ; Warren, several ;
Washington, 3 ; Wayne, 6 ; Wilkes, 100
—
20 counties.
Whooping-Cough.—Ashe, 3 ; Chowan,
many ; Durham, some ; Granville ; Har-nett,
a few ; Nash, a few ; Onslow, 10 ;
Orange, a few ; Robeson ; Warren, sev-eral
; Washington, 40 ; Wilkes, 25 ; Yad-kin,
12—13 counties.
Scarlatina.—Cumberland, 3 ; Har-nett,
2 ; New Hanover, 7 ; Richmond, 3 ;
Diphtheria.—McDowell, 1 ; Macon, 1;
Typhoid Fever.—Alexander, 2 ; Beau-fort,
1 ; Buncombe, 2 ; Chowan, several ;
Cleveland, 2 ; Columbus, 1 ; Davidson, 1 ;
Gaston, several ; Greene, 2 ; Iredell, 1
;
Jackson, 4 ; McDowell, 2 ; Macon, 4 ;
Mecklenburg, 8 ; Mitchell, 4 ; Nash, 1
; New Hanover, 4 ; Onslow, 2 ; Perquimans,
a few ; Person, 2 ; Pitt, a few ; Rocking-ham,
1; Sampson, a few; Union, 10;
Wake, 1 ; Wautauga ; Wilkes, 1 ; Yadkin,
1—2.8 counties.
Malarial Fever.—Catawba ; Cleve-land,
4 ; Columbus, 4 ;Halifax ; Harnett ;
Jones ; Mecklenburg ; New Hanover, in
all parts ; Onslow ; Person ; Polk, a little ;
Robeson ; Sampson ; Vance ; Warren and
Wilson, in all parts—16 counties.
Malarial Fever, P e r n i c i o u s.—
Jones, 1.
Malarial Fever, Hemorrhagic.—
Cumberland, 1
; Jones, 1.
Mumps.—Clay ; Sampson ; Wayne.
Diarrhceal Diseases, including Dys-entery.
Alamance, in some neighbor-hoods,
local ; Bertie, local ; Bladen, local
Burke, throughout the county, general
Caldwell, a few cases ; Chatham, local
Cherokee, general ; Chowan, general
Cleveland, general ; Columbus, local
Cumberland, general ; Davidson ; Frank-lin,
general; Gaston, a few cases ; Gates,
local ; Greene, general ; Guilford, gener-al
; Halifax, general ; Harnett ; Hender-son,
general; Hertford, local; Iredell,
general ; Jones ; Lincoln, general ; Mc-
Dowell ; Macon, general ; Madison, local ;
Martin, general; Mecklenburg; Nash,
general ; Northampton, local ; Pasquo-tank,
in children, local ; Person, local .
Robeson, local ; Rockingham, general ;
Sampon, general ; Stokes, general ; Surry,
general ; Transylvania, local ; Union, in
some portions, general ; Warren, general ;
Yadkin, local—42 counties.
Influenza.—Jackson ; Northampton ;
Vance.
Pneumonia.—Gaston ; Jackson.
Smallpox.—Iredell, 8; Wilson, 1.
Cholera in Hogs.—Bertie ; Onslow ;
Wilkes.
Cholera, in Chickens.— Harnett.
Distemper, in Horses.—ciav.
24 BULLETIN OF THE NORTH CAROLINA BOARD OF HEALTH.
Roup, in Chickens.—Clay.
No diseases of importance are reported
from Cabarrus, Carteret, Edgecombe,
Haywood, Pender, Polk,Swain and Yancy.
No reports have been received from the
following counties having Superintend-ents
of Health : Anson, Brunswick, Cra-ven,
Duplin and Rowan.
Summary of Mortuary Reports for May
1898 (Twenty-two Towns).
Only those towns from which certified
reports are received are included:
White. CoVd. Total.
Aggregate popula-tion
67,789 53.621 121,410
Aggregate deaths . . 75 94 ^9
Representing tem-porary
annual
death rate per
1,000 13.3 21.0 16.7
Causes of Death
.
Typhoid fever o 2 2
Malarial Fever. ... o 5 5
Whooping-cough..011 Measles o 2 2
Pneumonia 1 4 5
Consumption 7 6 13
Brain diseases 6 5 11
Heart diseases.- ... . 4 9 13
Neurotic diseases .112
Diarrhceal diseases
.
14 10 24
All other diseases . . 40 49 SS
Accident 1 1 2
Suicide 1 o 1
75 94 169
Deaths under five
years 24 37 61
Still-born 6 15 21
BULLETIN OF THE NORTH CAROLINA BOARD OF HEALTH.
Mortuary Report for May, 1898.
25
Towns
26 BULLETIN OF THE NORTH CAROLINA BOARD OF HEALTH.
County Superintendents of Health.
Alamance Dr. J. K. Stockard.
Alexander Dr. T. F. Stevenson.
Alleghany
Anson Dr. E. S. Ashe.
Ashe Dr. L. C. Gentry.
Beaufort Dr. D. T. Tayloe.
Bertie Dr. H. V. Dunstan.
Bladen Dr. Newton Robinson.
Brunswick Dr. D. B. McNeill.
Buncombe Dr. I. A. Harris.
Burke Dr. J. L. Laxton.
Cabarrus Dr. J. S. Lafferty.
Caldwell Dr. A. A. Kent.
Camden No Board of Health.
Carteret Dr. F. INI. Clarke.
Caswell
Catawba Dr. D. M. Moser.
Chatham Dr. H. T. Chapin.
Cherokee Dr. S. C. Heighway.
Chowan Dr. R. H. Winborne.
Clay Dr. W. E. Sanderson.
Cleveland Dr. R. C. Ellis.
Columbus Dr. J. F. Harrell.
Craven Dr. L. Duffy.
Cumberland Dr. J.Vance McGougan.
Currituck No Board of Health.
Dare
Davidson Dr. John Thames.
Davie Dr. James McGuire.
Duplin Dr. F. H. Arthur.
Durham Dr. John M. Manning. •
Edgecombe Dr. L. L. Staton.
Forsyth Dr. John Bynum.
Franklin Dr. E. S. Foster.
Gaston Dr. J. H. Jenkins.
Gates Dr. R. C. Smith.
Graham No Board of Health.
Granville Dr. G. A. Coggeshall.
Greene Dr. Joseph E.Grimsley.
Guilford Dr. A. E. Ledbetter.
Halifax Dr. I. E. Green.
Harnett Dr. O. L. Denning.
Haywood Dr. J. Howell Way.
Henderson Dr. J. G. Waldrop.
Hertford Dr. John W. Tayloe.
Hyde No Board of Health.
Iredell Dr. Henry F. Long.
Jackson Dr. William Self.
Johnston
BULLETIN OF THE NORTH CAROLINA BOARD OF HEALTH. 27
[You are asked to fill out and mail one of these forms to the Superintendent of Health
of your County on or before the third of each month, that he may use it in making his
report to the Secretary of the State Board]
Have any of the following diseases occurred in your practice during the month
just closed. If so, state number of cases.
Whooping-cough— Typhoid Fever
Measles Typhus Fever
Diphtheria Yellow Fever
Scarlet Fever Cholera
Pernicious Malarial Fever Small-pox
Hemorrhagic Malarial Fever Cerebro-spinal Meningitis
-
What have been the prevailing diseases in your practice ?
Has any epidemic occurred among domestic animals? If so, what?
What is the sanitary condition of your section, public and private ?
General Remarks
-M. D.
-189 N. C.
469-7-21-9.3-2500.
BULLETIN
OF THE
florth Carolina Board of Health
Published Monthly at the Office of Secretary of the Board, at Raleigh, N. C.
Geo. G. Thomas, M T>.,Pres., Wilmington.
8. Wkstray Battle, M. D.,..Asheville
W H. Hakrell, m. d Williamson,
John Whitehead. M. D., ...Salisbury.
C. J. O'Hagan, M. D
J. D Spice k.M.D
J L Nicholson, M. I> ,
A. W. Shaffer, San Kng
.. .Greenville.
Goldsboro.
Ricliliinds.
Raleigh.
Richard H. Lewis. M. D , Secretary ttnd Treasurer, Raleigh.
Vol. XIII. JULY, 1898. No. 4.
SMALLPOX IN NORTH CAROLINA.
During the past month there has been
a material spread of the disease both as to
the number of cases and localities infected.
When we last went to press, it was report-ed
as present at only two points—States-ville
and Vanderborg's Chapel, both in
Iredell county. At this present writing
(Jul}7 19), smallpox exists in addition at
Mooresville, 1 case; Elmwood, 2—both in
Iredell ; Asheville, 1, which is nearly well;
Catawba, 6, in one family in southeastern
part of county ; Cleveland, in Rowan
county, 7; Reidsville, 1; Durham, 1.
When the Superintendent of Health of
Rowan county was first notified of the
existence of smallpox at Cleveland he
found 20 cases, 13 of whom had recovered.
They had been diagnosticated as chicken-pox,
urticaria, and pemphigus and no pre-cautions
whatever were taken in conse-quence.
The people, we are told, called
it " elephant itch "—not a bad name, as
the eruption of smallpox is about the big-gest
thing of its class, in what it means, at
any rate.
A negro from Cleveland went to Reids-ville
and was there two days with tbe
eruption of smallpox on him before he
was discovered. During that time he went
on an excursion and mingled promiscu-ously
with his people. One of these who
had been exposed went from Reidsville to
Durham in the beginning of the eruption
stage. Although sought for, he was not
found until next morning, after he had
slept in the same room with several others.
Reports from Asheville, Iredell county,
generally, Cleveland and Durham, show
everything in good shape except the re-luctance
in too many instances of the peo-ple
to be vacoinated. The reports, how-ever,
from Catawba county and Reidsville
are not at all satisfactory, and we fear a
spread of the disease in those localities.
IN REGARD TO SMALLPOX.
While the instructions for quarantine
and disinfection issued by the board sev-eral
years ago in compliance with the
!' quirements of Section 9 of the Act in
Relation to the Board of Health, really
embody all that is necessary, if faithfully
carried out, for the restriction of contagi-ous
diseases, it is thought advisable in
view of the prevalence of smallpox in one
30 BULLETIN OF THE NORTH CAROLINA BOARD OF HEALT H.
section of the State, and the strong proba-bility
of its spreading, to issue fuller and
more specific directions as to the manage-ment
of that particular disease.
In order to be perfectly plain it may be
necessary to be somewhat elementary and
the well informed health officer must not
consider what is said as a reflection upon
his intelligence and knowledge. It should
be remembered that this is merely a sup-plement
to the "Instructions" and the
two must be read together.
We will consider the subject in its rela-tion,
i, to the patient; 2, to the physician;
3, to the general public; 4, to the muni-cipality,
and finally, 5, to vaccination.
I. The Patient.—Owing to the tenden-cy
in human nature to put away disagree-able
things it seems that in many cases
the attending physician is loath to admit
that the case is one of smallpox and calls
it chickenpox, urticaria and even pem-phigus,
while the people, in one locality
at least, denominate it "elephant itch."
When a mistake is made in the diagnosis,
or until it is correctly made, no precau-tions
are taken, as a rule, and free inter-course
with the patient being allowed, the
infection is spread. The diagnosis is not
difficult, but as no chances should be
taken, the obviously proper thing to do
whenever there is any doubt about it is to
manage the case as if it were smallpox.
When smallpox is prevailing every one
with an eruption who a few days before
its appearance had headache, pain in the
back and fever, should be strictly quaran-tined
until time has settled the question.
Above all things the patient should be
properly cared for. This is not a super-fluous
suggestion—as it ought to be—for
it occasionally happens that the cry of
smallpox produces such an acute and gen-eral
panic that the poor sufferer is more
or less neglected, for a while at least.
There is no excuse for this, as thoroughly
vaccinated persons can handle such cases
with as little danger as they could measles.
2. The Physician.-—The greatest care
should be taken by the physician to avoid
carrying the infection to others. He
should have a special suit of clothes dur-ing
the warm weather of some material
that will wash—or better, perhaps, a long
gown of linen or cotton, buttoning close
around the neck above the collar and
tightly around the wrists, to be worn over
his ordinary clothes, with a cap of paper
or oiled silk completely covering his hair,
while his feet are protected by rubber
shoes. The garments should be donned
in an uninfected room, or out of doors if
there is no room, and removed upon re-turning
to the same from the room of the
patient. If the disease is present in only
one house, the special suit can be left
there but not in the room with the patient.
If, however, there be cases in other houses
to be seen, it can be rolled up and carried
in a close-shutting hand-bag. To make
assurance doubly sure it would be well
after the rounds for the day have been
made to hang it up in a box or closet or
wardrobe in an unoccupied room and dis-infect
it with one of Schering & Glatz's
small formaldehyde lamps. Before going
to bed hang it out of the window to remove
the formaldehyde odor. Do not forget to
disinfect the hand-bag also, if one is used.
Before leaving the premises the hands and
face, (beard particularly) should be wash-ed
with some reliable antiseptic—bichlo-ride
of mercury, 1 to 2000, or a 2 per cent,
solution of carbolic acid, for example.
3. The General Public.—The people
should bear in mind the fact that there is
no reason whatever for becoming panic-stricken
at the announcement of smallpox
in their community—by no means such
good reason as on the appearance of diph-theria
or scarlet fever. In smallpox alone
of all the contagious diseases have we a
sure preventive—vaccination. All one has
to do in such circumstances is simply to i;et
his physician to successfully vaccinate him
and go on his way rejoicing without the
BULLETIN OF THE NORTH CAROLINA BOARD OF HEALTH. 3 1
least fear or anxiety. Should the disease
become epidemic and the first vaccination
fail to take, it would be well for the sake
of certainty to be re-vaccinated at the end
of a week. It is to be borne in mind that
this advice regarding the necessity for
vaccination applies with almost equal
force to those persons who have been
vaccinated in childhood and have reached
adult life. For while it is true that the
primary vaccination done in early life
may in most instances protect the persons
through life, this immunity for so long a
period cannot be assured, and to make
themselves safe, it is most advisable to
have the vaccination done again. This
will appear reasonable, when it is remem-bered
that if the person vaccinated in
early life does contract smallpox, it will
only develop into a very mild form, vario-loid
; but it must not be forgotten that this
mild form, this varioloid is of the same
nature as the severer forms and will excite
in the uuvaccinated typical and often fatal
smallpox. Good citizens should and
would hold up the hands of the powers
that he and cheerfully render every possi-ble
assistance in carrying out thoroughly
and loyally the plans devised for stamp-ing
out the disease. No dependence, to
the exclusion of vaccination, should be
placed upon quarantines, for inland quar-antines
are notoriously ineffective.
4. The. Municipality.—The authorities
of any city or town liable to become in-fected
from other points should not wait
until the disease actually appears in their
own community but make their prepara-tions
for taking care of and checking its
spread in advance. The proper manage-ment
of smallpox demands a hospital con-sisting
of at least four rooms—preferably
two small houses of two rooms each—for
the separate accommodation of both sexes
of the two races; and a larger house for
the detention of those known to have been
exposed, until the period of incubation
—
say fifteen days—has passed. As we never
think lightning is going to strike us such
complete anticipatory preparation can
hardly be expected, but preliminary ar-rangements
ought to be made for provid-ing,
with the least possible delay, these
necessary buildings. Tents would answer
in warm weather. When a case appears
in the town itself an abundant supply of
first-class virus should be ordered by wire,
arrangements should be made with a suffi-cient
number of physicians to perform the
work quickly, and everybody not giving
satisfactory evidence of previous vaccina-tion
should be vaccinated. If not already
in existence, such ordinances as may be
necessary, with sufficient penalties attach-ed,
should be immediately enacted. Sec-tion
25, chapter 214, Laws of 1893, gives
all incorporated towns the fullest power
in this matter, whether given in their
charters or not.
5. Vaccination.—There is, we regret to
say, considerable opposition to vaccina-tion
among the people. This is due chiefly
to the prejudice of ignorance, and is,
therefore, more difficult to overcome.
There is not sufficient ground for this
prejudice. While it is true that "bad
arms" occasionally follow vaccination it
is but rarely, if the proper precautions are
taken in making the vaccination and
decent care is taken of the arm afterwards.
If good bovine virus is used there is no
danger of the transmission of any disease.
The heifers in the best establishments are
always tested for tuberculosis—even if
tuberculosis can be transmitted in that
way, which is extremely doubtful, to say
the least. Admitting that there is some
ground, though by no means sufficient,
for the breadwinner of a family to object
for himself, there is none for his children.
In this connection we believe it would be
not only humane but wise, from a purely
business point of view, for all large em-ployers
of labor, as mill-owners with us,
to insist on the vaccination of all opera-tives,
agreeing, in case of disability there-
32 BULLETIN OF THE NORTH CAROLINA BOARD OF HEALTH.
from, to pay half wages or at least enough
to prevent suffering.
Vaccination is one of the simplest of
operations, but many bad arms are un-doubtedly
traceable to its improper per-formance—
to the neglect of a little care.
Thorough asepsis should be observed.
The arm should be scrubbed clean with
soap and water, and the vaccination per-formed
with a sterilized instrument, the
point itself, which has already been ster-ilized,
if points are used, or if a steel in-strument
be employed, by wiping i clean
and passing it through the flame of an
alcohol lamp after each vaccination. To
avoid the necessity of carrying the alcohol
lamp around in house to house visitation,
it has been suggested that the vaccinator
carry a paper of fair-sized needh s with
hi 111, and with these needles scarify the
place where he intends to introduce the
virus, using a fresh needle for each
patient. Do not make the scarifications
over a quarter of an inch square, and
avoid, if possible, drawing blood, as the
clot in drying takes up and holds some of
the virus. It is recommended three or
four of these little scarifications be made
quite close together in a group. The best
opinion at present is that pus infection
is less liable to follow the use of the
glycerinated lymph, though the points
have many friends on account of their
convenience and the rapidity with which
they can be used. Vaccinate. Vaccinate!
VACCINATE ! ! VACCINATE ! ! !
REVIEW OF DISEASES FOR JUNE. 1898.
(SEVENTY-SIX COUNTIES REPORTING.)
Eighty-five counties have Superinten-dents
of Health.
Except in the case of the more conta-gious
and dangerous diseases, the Super-intendent
has, as a rule, to rely upon his
own information alone, since few physi-cians
can be induced to report cases of
non-contagious diseases to him.
Where the number of cases is not given,
or the prevalence of a disease otherwise
indicated, its mere presence in the county
is to be understood as reported.
For the month of June the follow-ing
diseases have been reported from the
counties named:
Measi.es.—Davidson, 6 ; Forsyth, in
all parts; Martin, 4; Mecklenburg, a few;
Pitt; Rockingham; Vance, 3; Warren;
Wayne, 2—8 counties.
Whooping-Cough. — Ashe, 10; Dur-ham;
Granville; Harnett, afew; Northamp-ton;
Onslow, 10; Pasquotank, 2; Rocking-ham;
Vance, 12; Warren; Washington,
25; Yadkin, man)-—12 counties.
Scarlatina.—Catawba, 2; Rocking-ham,
1.
Typhoid Fever.—Alexander, 1 1 ; Beau-fort,
3; Burke, 4; Cabarrus, 10; Caldwell,
in several sections; Catawba, 8; Cherokee,
4; Clay, 2; Cleveland, 12; Columbus, 3:
Davidson, 4; Durham, 2; Edgecombe,
several; Gaston, in nearly all parts;
Greene, 3; Guilford, several; Harnett, a
few; Henderson, 1; Hertford, 3; Iredell,
in all parts; Jackson, 16; Jones, 2; Lin-coln,
4; Macon, 18; Madison; Martin, 5;
Mecklenburg; Mitchell, 20, malignant in
type, chiefly in the western part; Nash, a
few; New Hanover, 8; Northampton;
Orange, 2; Pasquotank, 8; Pender, 1; Per-quimans,
in all parts, 12 cases; Pitt, gen-eral;
Polk, 1; Randolph, 5; Robeson;
Rockingham, 3; Rowan; Rutherford, a
few; Sampson, in many parts; Stokes, 3
Surry, 5; Union, 25; Vance, in many parts;
Wake; Washington, 1; Waiauga, in all
parts, 15; Wayne, 3; Wilkes; Yancey, a
few—53 counties.
Maeariae Fever. — Cabarrus, Ca-tawba,
in all parts; Chatham; Columbus;
Davidson, in all parts; Durham, in nearly
all parts; Greene; Halifax; Harnett, along
the Cape Fear; Iredell; Johnston; Jones;
Lincoln, a few cases; New Hanover,
BULLETIN OF THE NORTH CAROLINA BOARD OF HEALTH. 33
Northampton, in all parts; Onslow;
Orange, a few; Person; Robeson; Rowan;
Union; Warren, in all parts to a limited
extent; Wayne; Wilson, in all parts—24
counties.
Malarial Fever, Pernicious —Har-nett,
1.
Malarial Fever, Hemorrhagic—
Cabarrus, 2.
Uiarrhoeal Diseases (including dys-entery).—
Bertie; Cabarrus, throughout
the county, general; Chowan, general;
Cleveland; Gates; Greene; Haywood, gen-eral;
Henderson; Jackson; Lincoln; Mc-
Dowell; Macon, general ; Or slow, general;
Pasquotank ; Perquimans, general; Person;
Robeson; Rockingham, general; Ruther-ford;
Sampson, in many parts; Stokes,
general; Surry, general; Transylvania;
Union, general; Warren, in all parts to a
limited extent; Washington, general; Yad-kin;
Yancey, in many parts—27 counties.
Pneumonia. — Cleveland ; Jackson;
Onslow, 2.
Smallpox.—Buncombe, 1; Catawba, 6
in south* astern part; Iredell, 18—in hos-pital
at Statesville 14, at Mooresville 1,
at Vanderborg's Chapel 1, at Klmwood,
2; Rockingham, 1 in Reidsville; Rowan,
20 at Cleveland.
Glanders.—Mecklenburg, 3 cases in
children reported from lower part of
county, contracted from a horse. They
were not very severe, and are now well.
The horse was burned and the children
isolated. No new cases have occurred
among animals or human beings. Acute
coryza, enlarged glands of neck and fever
were the symptoms noted.
Cholera in Chickens.— Clay.
Cholera in Hogs.—Gates, Jackson,
Onslow.
Distember in Horses.—Jackson.
Hydrophobia —Catawba.
Summary of Mortuary Reports for June.
1898 (Twenty-four Towns).
Only those towns from which certified
reports are received are included:
White. Cord. To/a/.
Aggregate popula-tion
87,598 66,010 153,608
Aggregate deaths . . 109 130 239
Representing tem-porary
annual
death rate per
1,000 15.0 23.6 18.7
Causes of Dca/h
.
Typhoid fever 7 9 16
Malarial Fever ... 2 4 6
Whooping-cough . . 1 1 2
Pneumonia 3 2 5
Consumption 6 10 16
Brain diseases 6 4 10
Heart diseases 8 6 14
Neurotic diseases 033 Diarrhceal diseases. 27 34 61
All other diseases. . 46 51 97
Accident 3 6 9
109 130 239
Deaths under five
years 43 54 97
Still-born 1 7 8
34 BULLETIN OF THE NORTH CAROLINA BOARD OF HEALTH.
Mortuary Report for June, 1898.
Towns
and rkpokteks.
ASHEVILLE
Dr. M. H Fletcher.
CHARLOTTK
Dr. b\ O. Hawley
DURHAM
Dr. J. Ai. Manning.
fiOLDSBORO
D.J. Broadhurst,C.Ck.
OREENSBORO
J.S.Michaux, OityClk.
HENDERSON
Dr. Goode Cheatham
HILLSBORO
Dr. 0. D. Jones.
LENOIR
Dr. A. A. Kent.
MARION
Dr. B. A. Cheek.
MONROE
Dr. J.M.Blair
NEWBERN
Hugh J. L.ovick,C.Ck
OXFORD
Dr. G. A. Goggesball.
RALEIGH
V. F. Kale.Clerk K.H.
ROCKINGHAM
Dr. W. M. Fowlkes.
ROCKY MOUNT
Dr. G. L Wimberley.
SALEM
.s. ( :. Butner, Mayor.
SALISBURY
Dr. W. L. rump
SCOTLAND NECK
J A. Perry, Mayor.
TARBORO
Dr. L L. Staton.
WARRENTON
Dr. P. J. Macon
WASHINGTON
Dr. D. T. Tayloe.
WELDON
.J. T. Gooch, Mayor.
WILMINGTON
Dr. \V. D. McMillan.
WILSON
Dr. A. Anderson.
Popula-tion.
«
K.(MH)
5.0(H)
17.154
9,000
4.IMH)
2,0011
3,501
2,500
5.50U
2.51 M)
2,260
2,000
400
3f Messrs. Parke,
Davis & Co., and of the local committee.
We were greatly impressed by the mag-nitude,
completeness and finish of the
work done by this great drug house.
Particularly were we pleased with all the
arrangements for the preparation of the
diphtheria and other anti-toxins. No
pains or expense seemed to be spared to
produce the very best quality of every
thing. The morning session of this day
was given up to the papers by represen-tatives
of the various boards of health set-ting
forth the best methods of sanitary
work according to their experience, with
suggestions as to possible improvements.
The evening session was devoted to the
discussion of the purification of drinking-water.
The last day was consumed
chiefly by a thorough consideration of
tuberculosis, etiologically, pathologi-cally,
therapeutically and sanitarily. The
paper of the day was by Dr. D. E. Sal-mon,
of the United States Bureau of Ani-mal
Industry on the variations of the
tubercle bacillus in birds, animals and
fishes. The general opinion seemed to be
in favor of the establishment of sanatoria
for tuberculous cases, supported in part at
least, by the State. We fear that such an
idea is visionary, and that the same
amount of money might be made much
more- effective in other ways in prevent-ing
the spread of tuberculosis. .
38 BULLETIN OF THE NORTH CAROLINA BOARD OF HEALTH.
Detroit is a very attractive city and is a
favorite meeting place for all sorts of or-ganizations.
We can now understand
whv it should be.
PURE MILK.
We are pleased to learn from the news-papers
that the Charlotte Medical Society,
in consequence of a paper read before it
by Dr. I. W. Faison on "Some of the
Dangers of Milk," has appointed "a com-mit
tae to investigate the entire milk
question and report at the next meeting."
Good for the Charlotte Medical Society!
We hope their action may result in some-thing
of practical value. Nearly two
years ago at a health conference in the
same city we read a paper on the " Infec-tiousness
of Milk, '
' in which we expressed
the hope that that progressive town would
take the initiative in establishing muni-cipal
regulation of the milk supply, but
nothing came of it. We hope to return
to this subject when we have more space.
DISINFECTANTS AND DISINFECTION.
Some body has said that the best exe-cutive
officer is the one who can get the
most work out of other people. Acting
on that principle we propose, after mak-ing
our acknowledgements, to reprint from
The Sanitary Inspector, the official bul-letin
of the Maine Board of Health, the
very complete circular on the above sub-ject,
the result of "the laborious work of
months" by the excellent secretary, Dr.
Young. We have already printed and
circulated in "Instructions for Quarantine
and Disinfectants '
' information as to all
the older disinfections,